Acta Dermato-Venereologica 99-2CompleteContent | Page 34

SHORT COMMUNICATION Porokeratosis Ptychotropica on the Penis and Scrotum: A Case Report Yue-Tong QIAN 1 , Sergio VANO-GALVAN 2 , Jia-Wei LIU 1 , Wei LIU 1 and Dong-Lai MA 1 * 1 Department of Dermatology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100730, PR China, and 2 Department of Dermatology, Hospital Ramon y Cajal, Madrid, Spain. *E-mail: [email protected] Accepted Oct 16, 2018; E-published Oct 17, 2018 Porokeratosis is a heterogeneous group of skin disor- ders. Five clinical variants have been described: classic porokeratosis of Mibelli, disseminated superficial actinic porokeratosis, linear porokeratosis, punctate porokerato- sis, and porokeratosis palmaris et plantaris disseminata. In 1995, Lucker et al. (1) described a subtype of poro- keratosis: porokeratosis ptychotropica (PP). Clinically, this lesser-known entity most commonly affects body folds, especially the gluteal cleft, with or without invol- vement of the extremities. Male genitalia involvement is rare (2). We report here a special case of PP presenting with pruritic brownish verrucous plaques on the penis and scrotum. CASE REPORT A 48-year-old man presented with pruritic plaques on his penis and scrotum. The plaques had increased in size progressively over the last 20 years. Initial clinical presentation consisted of an itchy soybean-sized red scaly papule on the penis, but the lesions evolved to a verrucous scaly plaque, with a well-defined border ac- companied by satellite lesion on the scrotum (Fig. 1). The patient reported having received topical treatment with 5-fluorouracil cream, with no resolution. He had no history of previous skin or general medical disor- ders. There was no family history of similar lesions. Routine haematological evaluations and serological tests for sexually transmitted diseases (HIV, hepatitis viruses, syphilis) were negative. A skin biopsy from the peripheral margin of the lesion on the penis re- vealed hyperkeratosis, acanthosis, and the presence of multiple cornoid lamellae. The dermis showed a mild lymphohistiocytic inflammatory infiltrate (Fig. 2). A diagnosis of porokeratosis ptychotropica was made. The patient was treated with pimecrolimus. After 3 months the lesions showed no improvement, but there was temporary relief of pruritus. 246 Fig. 1. Brownish, well- demarcated, hyper­ trophic, scaly, verrucous plaque on the penis and scrotum. Fig. 2. Histopathology. (a) Hyperkeratosis, acanthosis, and the presence of multiple cornoid lamellae in the epidermis with a mild lymphohistiocytic inflammatory infiltrate in the dermis. (b) Multiple cornoid lamellae and disappearance of the granular layer underneath (haematoxylin and eosin (H&E), original magnification a: ×40, b ×100). doi: 10.2340/00015555-3074 Acta Derm Venereol 2019; 99: 246–247 This is an open access article under the CC BY-NC license. www.medicaljournals.se/acta Journal Compilation © 2019 Acta Dermato-Venereologica.