Porokeratosis - Porokeratosis

Japanese: 汗孔角化症 - かんこうかくかしょう（英語表記）Porokeratosis

What is the disease?

The skin in the center of the lesion atrophy ( Ishku ) And the keratin Periphery ( Henen ) This is a type of dyskeratosis that presents irregular, annular plaques that are raised like banks on the skin, and there are various types (Figure 24). Malignant tumors may develop.

What is the cause?

Mibelli type porokeratosis is an autosomal dominant genetic disease, but the exact cause is unknown (the causative gene has not been identified). Disseminated superficial ( Public opinion poll ) The causative gene for (actinic) porokeratosis is also unknown, but it is thought to be caused by exposure to ultraviolet rays. Skin rash ( Disappointment ) is thought to induce

How symptoms manifest

The lesions consist of irregular circular or oval raised areas with atrophic skin in the center. In Mibelli type porokeratosis, the lesions appear sporadically, whereas in other types, the lesions are multiple.

Testing and diagnosis

The diagnosis is easy based on the characteristic clinical symptoms. The skin margins of the affected area show thickening of the epidermis and increased keratinization. Parakeratotic casts ( During the creative process ) (cornoid lamella) is a wedge-shaped structure that is attached to the epidermis. Invagination ( Learning ) At the ingrown area, Granular layer ( Curry ) There is a sparse lymphocytic infiltrate in the dermis.

Clinically Common warts ( Human population ) , Callus ( Benchish ) (Octopus), Lichen planus ( Henpeitaisen ) , Psoriasis vulgaris ( Human life ) Distinguishing it from actinic keratosis is problematic. If it is difficult to distinguish, a biopsy is performed to take a sample of tissue for examination.

Treatment methods

1) Apply Zahne Ointment to the affected area twice a day.

② Apply Keratinamin Ointment (containing 20% urea) or Urepearl Ointment (containing 10% urea) to the affected area twice a day.

③ Apply 5% salicylic acid in petrolatum to the affected area two to three times a day.

④ Apply Bon Alpha Ointment (Vitamin D Ointment) to the affected area twice a day.

⑤Liquid nitrogen ( Chitso ) Cryotherapy, _CO2 laser, electric Cauterization ( Presentation ) ,skin Debridement ( Art ) We also sometimes carry out the following.

It is important to be careful about the development of malignant tumors.

What to do if you notice an illness

It is important to see a dermatologist to receive a correct diagnosis and appropriate treatment. Since malignant tumors can develop, a dermatologist's examination is essential.

どんな病気か

　病変部中心の皮膚が萎縮(いしゅく)して、角質が辺縁(へんえん)で堤防状に隆起した不規則な環状局面を示す角化異常症で、さまざまな型があります（図24）。悪性腫瘍が発生することがあります。

原因は何か

　ミベリ型汗孔角化症は常染色体優性遺伝の病気ですが、詳しい原因についてはわかっていません（原因遺伝子が特定されていない）。播種状表在性(はしゅじょうひょうざいせい)（光線性）汗孔角化症も原因遺伝子はわかっていませんが、紫外線が皮疹(ひしん)を誘発していると考えられています。

症状の現れ方

　皮疹は、円形ないしは楕円形の不規則な環状の隆起局面で、中心部の皮膚は萎縮しています。ミベリ型汗孔角化症では病変は散発性に現れますが、ほかの型では病変は多発します。

検査と診断

　特徴的な臨床症状から診断は容易です。病変部皮膚の辺縁部には、表皮の肥厚と角質の増生がみられます。その間に錯角化性円柱(さくかくかせいえんちゅう)（コルノイドラメラ）が、クサビ状に表皮に陥入(かんにゅう)しています。陥入部位では顆粒層(かりゅうそう)は欠如しています。真皮には、まばらなリンパ球の浸潤があります。

　臨床的には尋常性疣贅(じんじょうせいゆうぜい)、胼胝腫(べんちしゅ)（たこ）、扁平苔癬(へんぺいたいせん)、尋常性乾癬(じんじょうせいかんせん)、日光角化症との区別が問題になります。区別が困難な場合は、組織の一部を採取して調べる生検を行います。