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Retinoids in Keratinization Disorders
Published in Ayse Serap Karadag, Berna Aksoy, Lawrence Charles Parish, Retinoids in Dermatology, 2019
Disseminated superficial actinic porokeratosis is characterized by bilateral atrophic lesions with a raised keratotic margin, occurring particularly on the extensor surfaces of limbs including hands or feet. Generally, the condition spares the palms, soles, and mucous membranes. Characteristic features include xerotic lesions with a central atrophic zone surrounded by a well-demarcated hyperkeratotic border. The disease is dominantly inherited in most patients, but sporadic variants do occur. There is a slightly increased risk of malignant skin cancers.
Linear hyperpigmentation
Published in Dimitris Rigopoulos, Alexander C. Katoulis, Hyperpigmentation, 2017
Histologically, the EN shows increased thickness of the epidermis. The rare epidermolytic EN variety is characterized by epidermolytic hyperkeratosis resembling features seen in bullous ichthyosiform erythroderma. The acantholytic EN variety has features resembling Darier disease. Linear porokeratosis has features resembling disseminated superficial actinic porokeratosis.
Benign lesions
Published in Richard P. Usatine, Daniel L. Stulberg, Graham B. Colver, Cutaneous Cryosurgery, 2014
Richard P. Usatine, Daniel L. Stulberg, Graham B. Colver
Porokeratosis is a chronic disorder of keratinization producing papules and plaques with ridge-like borders known as cornoid lamellae. The most common variant is disseminated superficial actinic porokeratosis (Figure 8.25). New lesions may continue to appear for years and have a considerable cosmetic effect. No treatment is entirely satisfactory but cryosurgery is one approach that is often acceptable to patients despite the hypopigmentation that often follows. Short freezes of 5–10 s with a spray are best. The linear and Mibelli’s variations of porokeratosis are no more amenable to resolution but a test area is always worthwhile. In one study, 18 of 20 porokeratosis Mibelli’s lesions were successfully treated with a 30-second freeze.26
Efficacy and safety of 1927 nm fractional Thulium fiber laser for the treatment of melasma: a retrospective study of 100 patients
Published in Journal of Cosmetic and Laser Therapy, 2019
G. Kurmuş, A. Tatlıparmak, B. Aksoy, E. Koç, Z. Aşiran Serdar, C. Ergin
The third line of melasma therapy includes laser and light based treatments for refractory cases. Ablative and non-ablative fractionated lasers are the newer treatment options for melasma (2). Fractionated lasers create columns of microthermal damage surrounded by untreated skin areas. These unaffected areas lead to better response and more rapid recovery. Non-ablative fractional lasers target water-containing tissues, and therefore, they can cause coagulative damage. There are four non-ablative fractional lasers (wavelengths 1440nm, 1540 nm, 1550 nm, and 1927 nm). The 1927 nm thulium fiber laser has greater absorption and coefficient than the other non-ablative fractional lasers (2), and therefore, it can target epidermal pigmentation (4). Previous studies and case reports have established the effectiveness of the 1927 nm thulium laser for the treatment of melasma (3–5), photoaging (8,9), disseminated superficial actinic porokeratosis (10), rejuvenation (11), lichen sclerosus (12), actinic keratoses (13), actinic cheilitis (14), sclerodermoid graft versus host disease (15), pattern hair loss (16), and seborrheic keratoses (17).
Histologic analyses on the response of the skin to 1,927-nm fractional thulium fiber laser treatment
Published in Journal of Cosmetic and Laser Therapy, 2018
In Ho Kwon, Youin Bae, Un-Cheol Yeo, Jin Yong Lee, Hyuck Hoon Kwon, Young Hee Choi, Gyeong-Hun Park
The 1,927-nm laser has high absorption in water and delivers energy to both the epidermis and the upper dermis (1). As the laser can target dermal as well as epidermal lesions, it can improve not only epidermal processes including pigmentation but also dermal conditions with induction of collagen regeneration (1). Previous clinical studies of the 1,927-nm fractional thulium fiber laser have demonstrated its effectiveness in the treatment of pigment disorders including melisma (1–5), lentigines (5,6), and postinflammatory hyperpigmentation (7), and other superficial lesions including seborrheic keratosis (8), actinic keratosis (9), and disseminated superficial actinic porokeratosis (10). Furthermore, several studies have also shown that the laser improves photoaging (6), wrinkling (1,3,5,6), skin laxity (1) and texture (3), enlarged skin pores (3), and scar (11), which seems to result from the dermal effect of the laser.
Effective treatment of disseminated superficial actinic porokeratosis with chemical peels – customary treatment for a rare disease
Published in Journal of Dermatological Treatment, 2020
Berenice M. Lang, Adriane Peveling-Oberhag, Sebastian Zimmer, Joanna Wegner, Anna Sohn, Stephan Grabbe, Petra Staubach
Disseminated superficial actinic porokeratosis (DSAP) is a rare dermatologic disorder of the epidermis most commonly occurring in UV exposed regions of the body. The appearance of multiple brownish papules with hyperkeratotic margins each usually not bigger than 1 cm in diameter is a characteristic. Risk factors include chronic exposition to UV irradiation and immunosuppressive therapies or diseases. Pale skin types (Fitzpatrick I and II) and female gender are more often affected and it peaks around the 4th decade (1). Autosomal-dominant inheritance is reported in some cases (2,3). Management of the disease includes esthetical demands but also prevention of epithelial skin cancer since neoplastic transformation into squamous cell carcinomas is described (4–6).