What is the prognosis of porokeratosis?

Updated: Oct 09, 2020
  • Author: Amarateedha Prak LeCourt, MD; Chief Editor: William D James, MD  more...
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The prognosis is generally excellent. This is especially true for disseminated superficial porokeratosis (DSP).

Large lesions of porokeratosis, linear porokeratosis, or porokeratosis in an immunocompromised patients should be monitored carefully for the development of cutaneous malignancies within the porokeratosis lesions. Malignant transformation can occur in about 7.5% of patients. [42, 43, 44] Lesions that are large, long-standing, or linear have the greatest risk of developing an associated malignancy. [45] Chromosomal instability and reduced immune surveillance with overexpression of p53 are hypothesized to play a role in the development of cutaneous malignancies within porokeratosis. [46, 47, 48, 49, 50]

Porokeratosis of Mibelli (PM) circumferentially involving the digits may induce pseudoainhum. Most lesions are asymptomatic. Ulcerative lesions have been described. Giant PM in a facial or acral location may cause destruction of underlying soft tissue or pseudoainhum with amputation. [51]

Very rarely, porokeratosis-associated squamous cell carcinomas may metastasize and cause death. [52, 53]

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