Annular papules in the perineal area: Porokeratosis

A 50-year-old man came to the dermatology department with a five-year history of brownish annular papules with hyperkeratotic rims in his perineal area which were aggravated by hot weather [Figure 1]. Many of his family members had a similar dermatosis. Histopathologic examination of the studied sections revealed a column of parakeratotic cells within an invagination of the epidermis through the stratum corneum. The granular layer was absent under the cornoid lamella. Based on the clinical and histopathological findings, a diagnosis of porokeratosis was made. Porokeratosis involving the perineal area is rare and easily misdiagnosed. The pathogenesis of porokeratosis is not clear and some forms of this disease are inherited in an autosomal dominant fashion.¹ Treatment with oral acitretin and topical retinoids resulted in a temporary resolution of the lesions in this case.

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Figure 1:

Brown annular papules with hyperkeratotic rims in the perineal area

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