REPORT OF A CASE
A 79-year-old Filipino woman presented to our clinic with an annular plaque on the right anterior aspect of her thigh that she believed had been present all her life. The lesion was slowly enlarging and had recently become pruritic. The family history was noncontributory for similar lesions, and the lesion was not exacerbated by sunlight.Findings from her physical examination revealed a 4-cm annular plaque with a smooth atrophic center (Fig 1). The biopsy specimen revealed a coronoid lamella, confirming the diagnosis of porokeratosis.
Classic porokeratosis of Mibelli.
Many reports have been published of malignant degeneration in these lesions,1-4 including squamous cell carcinoma, basal cell carcinoma, and Bowen's disease. Given the potential for malignant change, cosmetic disfigurement, and occasional pain, removal of this patient's lesion was recommended. In other cases, no treatment with observation of the lesion may be optimal. Surgical excision
Spencer JM, Katz BE. Successful Treatment of Porokeratosis of Mibelli With Diamond Fraise Dermabrasion. Arch Dermatol. 1992;128(9):1187–1188. doi:10.1001/archderm.1992.01680190043004
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