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Diagnosis: Porokeratosis (Mibelli). Presented by Dr. Frank Cormia and Dr. Sam Atkinson.
The patient has had this disease since age 10, or for 65 years.
Fingers, toes, legs, arms, groin and perineum, and left ankle are the sites of these lesions.
Since age 10, this 75-year-old Jewish male has had slowly progressive enlargement and appearance of small, warty papules which enlarge serpiginously giving atrophic centers and warty borders. He has been treated by many dermatologists with multiple ointments, lotions, and creams topically, and electrodesiccation was attempted 15 years ago on one lesion without changes in the disease. These lesions are mildly pruritic.
Pertinent dermatologic findings were limited to multiple asymmetrical lesions listed below varying from keratotic papules to circinate on serpiginous plaques with raised brownish, warty margins surrounded by a thin linear ridge and atrophic, smooth, dry central portions. Where lesions occur on hairy areas, the
NEW YORK ACADEMY OF MEDICINE, SECTION ON DERMATOLOGY. Arch Dermatol. 1964;90(1):108. doi:10.1001/archderm.1964.01600010114028
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