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February 1972


Author Affiliations

Bethesda, Md

Arch Dermatol. 1972;105(2):297. doi:10.1001/archderm.1972.01620050095028

To the Editor.—  It is essential to distinguish between morphological lesions and clinical syndromes which may be comprised of several different morphological lesions. Drs. Mikhail and Wertheimer (somewhat intermixing the two) have primarily described the former in their list of clinical forms. Although several different porokeratosis lesion types have been reported, they have previously been associated with two syndromes — classic porokeratosis (Mibelli) and disseminated superficial actinic porokeratosis (Chernosky). Both syndromes have distinguishing morphological features; but the Mibelli type may have, in addition, hyperplastic or verrucose lesions, and the patients with the Chernosky type often have hyperplastic lesions.We have not claimed to describe a new lesion type but a new syndrome. The term porokeratosis plantaris, palmaris, et disseminata (PPPD) is merely descriptive. Certainly lesions of porokeratosis may be disseminated and numerous, and palmar and plantar lesions have been described (rarely in the Mibelli type and not at all in