Foster Charlotte, Tallon Ben
Histopathology Department, Middlemore Hospital Auckland, New Zealand.
Dermatology Division, Department of Anatomical Pathology, Pathlab 829 Cameron Road, Tauranga 3112, New Zealand.
Int J Clin Exp Pathol. 2022 Feb 15;15(2):56-62. eCollection 2022.
Porokeratosis is a disorder of keratinization with many clinical variants. The histological hallmark feature of porokeratosis is a cornoid lamella. Other accompanying features include lichenoid inflammation, atrophy towards the centre of the lesion, dermal cytoid bodies, and adjacent lichenoid changes. Lichenoid keratosis is a benign cutaneous condition, thought to largely represent a degenerating seborrheic keratosis or solar lentigo. The classical histologic appearances are characterized by parakeratosis, epidermal acanthosis, and a dense band of lichenoid lymphocytic infiltrate. Since a lichenoid inflammatory reaction pattern can be seen in porokeratosis it has the potential to be misdiagnosed as a lichenoid keratosis if the cornoid lamella is not identified or missed due to sampling selection. We critically review 104 cases of benign lichenoid keratosis to establish whether any of these cases had features to support a diagnosis of porokeratosis. With 9.6% of cases considered for re-classification, we review clues to reaching this histologic diagnosis.
汗孔角化症是一种具有多种临床变体的角化异常疾病。汗孔角化症的组织学标志性特征是鸡眼样板。其他伴随特征包括苔藓样炎症、向病变中心萎缩、真皮细胞样体以及相邻的苔藓样改变。苔藓样角化病是一种良性皮肤疾病，被认为主要代表退化性脂溢性角化病或日光性雀斑样痣。其典型的组织学表现为角化不全、表皮棘层肥厚以及一条致密的苔藓样淋巴细胞浸润带。由于在汗孔角化症中可见苔藓样炎症反应模式，如果未识别出鸡眼样板或因取材选择而遗漏，就有可能被误诊为苔藓样角化病。我们对104例良性苔藓样角化病病例进行了严格审查，以确定这些病例中是否有任何特征支持汗孔角化症的诊断。在9.6%的病例被考虑重新分类的情况下，我们回顾了做出这种组织学诊断的线索。
