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September 2006

A Thick Lichenified Plaque on the Ventral Penile Shaft—Diagnosis

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Arch Dermatol. 2006;142(9):1221-1226. doi:10.1001/archderm.142.9.1221-e

Histologic examination revealed a cornoid lamella characteristic of a porokeratosis. There was a central column of parakeratotic stratum corneum overlying a keratin-filled invagination. The granular layer was focally absent, and there was focal dyskeratosis. The adjacent skin exhibited epidermal hyperplasia, normal stratum corneum, and a patchy dermal lymphocytic infiltrate. The patient was diagnosed as having porokeratosis. One month of daily treatment with 1% fluorouracil cream was initiated. This therapy initially caused redness and irritation, followed by clearing of the lesion and complete resolution of itching. After the therapy was completed, the lesion became an asymptomatic, white to pink patch without scale. The patient was very pleased with the result.

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