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.