Disseminated superficial actinic porokeratosis (DSAP) occurs diffusely in sun-exposed areas, notably the legs and forearms. The exposed nature of the lesions can cause emotional distress among patients. Additionally, these lesions present a risk of transformation into invasive squamous cell carcinoma. Treatments for DSAP have had mixed results, especially for extensive lesions. We report 2 cases of DSAP responding to treatment with fractional photothermolysis.
A 47-year-old woman with Fitzpatrick skin type II presented with multiple, pruritic, scattered, red-brown macules with peripheral scale covering her lower extremities, clinically consistent with DSAP. Biopsy findings confirmed the diagnosis. Previous treatments included cryotherapy, topical diclofenac, tazarotene, and intralesional triamcinolone.
Chrastil B, Glaich AS, Goldberg LH, Friedman PM. Fractional Photothermolysis: A Novel Treatment for Disseminated Superficial Actinic Porokeratosis. Arch Dermatol. 2007;143(11):1447-1462. doi:10.1001/archderm.143.11.1450