ABSTRACT
The treatments available for disseminated superficial actinic porokeratosis (DSAP) have been limited and have variable efficacy. We report the largest case series to date of the use of Grenz ray therapy in 17 patients with DSAP. There was at least 50% improvement in DSAP lesions in all cases. Erythema, itching and burning were common side effects of Grenz ray therapy. We believe that Grenz ray therapy may be an effective treatment option for patients with DSAP.
Subject(s)
Porokeratosis/radiotherapy , X-Ray Therapy , Adult , Aged , Erythema/etiology , Female , Humans , Male , Middle Aged , Pain/etiology , Pruritus/etiology , X-Ray Therapy/adverse effectsSubject(s)
Porokeratosis , X-Ray Therapy , Humans , Porokeratosis/diagnosis , Porokeratosis/radiotherapy , X-RaysSubject(s)
Aminolevulinic Acid/analogs & derivatives , Photochemotherapy/methods , Porokeratosis/drug therapy , Porokeratosis/radiotherapy , Aftercare , Aged , Aminolevulinic Acid/administration & dosage , Aminolevulinic Acid/therapeutic use , Humans , Male , Pain/diagnosis , Pain/etiology , Porokeratosis/pathology , Pruritus/diagnosis , Pruritus/etiology , Treatment OutcomeABSTRACT
BACKGROUND: Disseminated superficial actinic porokeratosis (DSAP) is a rare keratinization disorder with potential malignant transformation, for which present treatment strategies show limited success. AIM: To evaluate the response of DSAP lesions to grenz ray radiotherapy (RTx). METHODS: Data of patients treated with RTx at University Hospital Zurich, Switzerland, between 2004 and 2015, were reviewed. Patients with DSAP, who received at least 1 RTx treatment session and who had been followed up for at least 4 weeks were included in the further data analysis. RESULTS: The study cohort consisted of 8 patients with a median age of 73 years (range 54-84). All were treated with grenz rays for DSAP. Most (7/8) patients showed complete clinical clearing of the lesions. All patients experienced temporary side effects of RTx, which resolved within 4 weeks after the last irradiation. CONCLUSION: We suggest radiotherapy with grenz rays as a treatment option for DSAP.
Subject(s)
Porokeratosis/radiotherapy , X-Ray Therapy , Aged , Aged, 80 and over , Female , Humans , Male , Middle Aged , Radiotherapy Dosage , Retreatment , Treatment Outcome , X-Ray Therapy/adverse effectsSubject(s)
Porokeratosis/diagnosis , Aged , Antineoplastic Agents, Alkylating/therapeutic use , Combined Modality Therapy , Dacarbazine/therapeutic use , Female , Foot Diseases/complications , Foot Diseases/drug therapy , Foot Diseases/surgery , Foot Diseases/therapy , Humans , Immunotherapy, Active , Lasers, Gas , Low-Level Light Therapy , Melanoma/complications , Melanoma/drug therapy , Melanoma/secondary , Melanoma/surgery , Melanoma/therapy , Porokeratosis/complications , Porokeratosis/radiotherapy , Skin Neoplasms/complications , Skin Neoplasms/drug therapy , Skin Neoplasms/surgery , Skin Neoplasms/therapy , Toes/surgeryABSTRACT
Hypericin is a photo-active dye originating from the St. John's wort. Two patients with disseminated superficial actinic porokeratosis (DSAP) were treated with photodynamic therapy (PDT) using topical hypericin. Although a partial response was obtained in one patient topical hypericin-PDT does not emerge as a promising treatment for DSAP.
Subject(s)
Perylene/analogs & derivatives , Photochemotherapy , Porokeratosis/radiotherapy , Administration, Topical , Aged , Anthracenes , Antineoplastic Agents/therapeutic use , Female , Humans , Middle Aged , Perylene/therapeutic useABSTRACT
We describe a case of intensively pruritic and partially bullous disseminated superficial actinic prorokeratosis, with acute flare-ups. Histopathological examination showed the characteristic cornoid lamella and subepidermal blister formation in one biopsy. Grenz ray treatment resulted in a marked regression of the skin lesions and pruritus.
Subject(s)
Porokeratosis/pathology , Pruritus/pathology , Skin Diseases, Vesiculobullous/pathology , Aged , Humans , Male , Porokeratosis/radiotherapy , Pruritus/radiotherapy , Radiation Dosage , Skin/pathology , Skin/radiation effects , Skin Diseases, Vesiculobullous/radiotherapy , Treatment OutcomeABSTRACT
BACKGROUND: Porokeratosis is a disorder of epidermal keratinization manifested clinically by a raised border and histologically by a cornoid lamella. While cutaneous malignancy has been reported to arise in porokeratosis, the risk remains unknown. In the past it has been associated with a history of radiation therapy. OBJECTIVE: The purpose of this study is to estimate the frequency of cutaneous malignancy arising in porokeratosis and define those patients who are at highest risk. METHODS: All cases in the English language literature in the last 30 years were reviewed. RESULTS: Twenty-one (7.5%) of 281 cases reported revealed a malignancy arising within porokeratosis. Large lesions, those of long-standing duration, and the linear type were at greatest risk. Radiation therapy was an infrequently identified risk factor. CONCLUSION: Porokeratosis is a premalignant condition, with certain groups of patients at greatest risk for malignant transformation.
