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Images in Clinical Practice
ARTICLE IN PRESS
doi:
10.25259/IJDVL_122_2021

Porokeratosis ptychotropica on the buttocks

Department of Dermatology, The First School of Clinical Medicine, Nanjing Medical University, Nanjing, China
Department of Dermatology, Taicang Hospital of Traditional Chinese Medicine, Suzhou, China
Department of Pathology, Taicang Hospital of Traditional Chinese Medicine, Suzhou, China
Corresponding author: Jianqing Feng, Department of Dermatology, Taicang Hospital of Traditional Chinese Medicine, Suzhou, China. fjq1688@126.com
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This is an open-access article distributed under the terms of the Creative Commons Attribution-Non Commercial-Share Alike 4.0 License, which allows others to remix, tweak, and build upon the work non-commercially, as long as the author is credited and the new creations are licensed under the identical terms.

How to cite this article: Feng Y, Feng J, Bao J. Porokeratosis ptychotropica on the buttocks. Indian J Dermatol Venereol Leprol, doi: 10.25259/IJDVL_122_2021

A 63-year-old man presented with a 20-year history of itchy, reddish-brown, well-demarcated, bilateral and symmetrical hyperkeratotic plaques on the buttocks, along with peripheral discrete papules [Figure 1a]. There was no similar family history. He was a known diabetic for five years and denied the use of immunosuppressants. Dermoscopy showed well-circumscribed areas with central scar like structures, peripheral scaling, irregular punctate and globular vessels along with brown pigment granules on a reddish brown background [Figure 1b]. Skin biopsy showed parakeratotic columns intercalating epidermis in some areas, in which dyskeratotic cells could be seen, and a lymphocytic infiltrate in the upper dermis, confirming the diagnosis of porokeratosis ptychotropica. The cause of this, may be due to the frequent mechanical friction by long term farming. Porokeratosis ptychotropica is a rare variant of porokeratosis initially described in 1995. It is clinically characterized by a keratotic ridge with a central groove and histologically by cornoid lamella which is the key to differentiate it from neurodermatitis, chronic eczema, psoriasis and epidermal nevus. Though effective therapeutic strategies are lacking, early diagnosis of this condition is important as there is 7.5% to 11% risk of malignant transformation.

Figure 1a:: Well-demarcated, reddish- brown, bilateral and symmetrical plaques with hyperkeratotic surface on the buttocks along with peripheral discrete papules
Figure 1b:: Well-circumscribed areas with central scar-like structures, peripheral scaling, irregular punctate and globular vessels along with brown pigment granules on a reddish brown background

Declaration of patient consent

The authors certify that they have obtained all appropriate patient consent.

Financial support and sponsorship

Nil.

Conflicts of interest

There are no conflicts of interest.


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