A 64-year-old man with a 35-year history of chronic plaque psoriasis developed disseminated superficial porokeratosis (DSP) while being treated with etanercept for extensive psoriasis. He commenced etanercept therapy, 25 mg twice weekly, in 2004, and the dose was increased to 50 mg twice weekly owing to slow improvement. After 9 months, the dose was reduced back to 25 mg twice weekly.
In 2006, DSP was noted over his abdomen and limbs (Figure 1). Lesions numbered in excess of 100, measuring between 1 and 3 cm in diameter. A biopsy specimen was obtained, and DSP was confirmed (Figure 2).
Stewart L, Howat A, Coulson I. Disseminated Superficial Porokeratosis Secondary to Immunosuppression Induced by Etanercept for Extensive Psoriasis. Arch Dermatol. 2010;146(10):1193-11974. doi:10.1001/archdermatol.2010.298