Aitkens Lorry, Byrne Joel, Jennings-Dover Charay, Potter Kathryn Anne
Department of Dermatology, Medical College of Georgia at Augusta University, Augusta, GA.
SkinPath Solutions, Smyrna, GA, USA.
Dermatol Reports. 2022 Dec 29;15(2):9634. doi: 10.4081/dr.2023.9634. eCollection 2023 Jun 7.
Porokeratosis (PK) is a disorder of keratinization with a clinical presentation of an atrophic center surrounded by a hyperkeratotic border. Lesions of porokeratosis carry a risk of malignant transformation with giant porokeratosis (GPK) being a high-risk variant. We report a case in which a single, large, erythematous, scaly plaque in an immunocompromised patient showed initial histopathological features consistent with psoriasis and subsequent histological features consistent with GPK. This plaque underwent malignant transformation to squamous cell carcinoma on three occasions. This case highlights that specimens taken from central portions of porokeratosis may resemble a variety of dermatoses histologically, including psoriasis, resulting in misdiagnosis as seen in our patient. When a patient presents with a diagnosis previously made that isn't responding to therapy as expected, repeat biopsy is appropriate.
汗孔角化症（PK）是一种角化异常性疾病，临床表现为中央萎缩，周围有角化过度的边界。汗孔角化症的皮损有恶变风险，巨大汗孔角化症（GPK）是一种高危亚型。我们报告一例免疫功能低下患者，其单个、巨大、红斑鳞屑性斑块最初的组织病理学特征与银屑病相符，随后的组织学特征与GPK相符。该斑块三次发生恶变，转变为鳞状细胞癌。该病例强调，从汗孔角化症中央部位取材的标本在组织学上可能类似于多种皮肤病，包括银屑病，从而导致误诊，就像我们的患者那样。当患者出现先前诊断但对治疗无预期反应时，重复活检是合适的。
