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Chulalongkorn Medical Journal

Abstract

Porokeratosis, a spectrum of disorders characterized by abnormal keratinization, includes the rare variant, porokeratosis ptychotropica, typically manifests with hyperkeratotic plaques on the buttocks and genital area. Its clinical mimicry to various skin diseases, coupled with under-recognition of the disorder, results in frequent misdiagnosis. This challenge is compounded by the resistance of porokeratosis ptychotropica to treatment.

We report a 62-year-old Thai male with persistent pruritic hypertrophic plaques affecting the genitogluteal area, extremities, and scalp over five years, unresponsive to diverse topical agents. Histopathological findings revealed acanthotic epidermis with a cornoid lamella, consistent with porokeratosis ptychotropica. He was given oral acitretin at a dosage of 25 mg every other day to 25 mg daily for 7 months, resulting in significant improvement.

This report introduces the first documented case of porokeratosis ptychotropica with scalp involvement, expanding our understanding of the disease manifestations. Although treatment of this disease poses challenges due to its resistance to many conventional treatments, this patient exhibited remarkable improvement following oral acitretin use.

DOI

10.56808/2673-060X.5409

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