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November 1988

Punctate Porokeratotic Keratoderma

Author Affiliations

From the Department of Dermatology, William Beaumont Army Medical Center, El Paso, Tex (Dr Friedman), and the Department of Dermatology, Mayo Clinic and Mayo Foundation, Rochester, Minn (Drs Pittelkow and Su). Dr Herman is in private practice, El Paso, Tex, and Dr Friedman is now with the Skin Therapeutics Institute, Encino, Calif.

Arch Dermatol. 1988;124(11):1678-1682. doi:10.1001/archderm.1988.01670110038008

• Two unrelated patients had numerous palmoplantar "music box spine" keratotic plugs and pits of 11 and 13 years' duration. Histologic examination revealed a compact column of parakeratosis resembling that of a cornoid lamella of porokeratotic conditions. Ultrastructurally in clinically affected skin, the stratum corneum contained numerous variable-sized pyknotic nuclei, and cells in the stratum granulosum contained fewer keratohyalin granules. The ultrastructural findings differed from those of porokeratosis of Mibelli and disseminated superficial actinic porokeratosis. The proper nosologic designation should be punctate porokeratotic keratoderma.

(Arch Dermatol 1988;124:1678-1682)