Case Number : Case 1377 - 02 October Posted By: Guest

Superficial actinic porokeratosis. The cornoid lamellae are involving the follicles.

Agree with porokeratosis, but I don't know how to classify this localized case. Facial porokeratosis? Follicular porokeratosis? Facial follicular porokeratosis?

Agree! The cornoid lamellae are exclusively involving the follicular infundibulum and there is associated dyskeratosis of underlying follicular epithelium.
Wonder if the better term would be Follicular Porokeratosis, described as a distinct variant of porokeratosis. The usual clinical presentation is that of keratotic papules though.
Great case!

My report:
Follicular porokeratosis with background subtle solar lentigo and inflammatory reaction.

Seems this is a rare variant that may have some clinically distinctive features. Our case was seen by a consultant dermatologist who thought it was a solar lentigo. None of the previous cases had co-existent solar lentigo. Thanks to Dr Ambi Sud for providing the following references.

Pongpudpunth M, Farber J, Mahalingham M. Follicular porokeratosis: distinct clinical entity or histologic variant? [i]J Cutan Pathol[/i]. 2009;36:1195-1199

Zhao M, Sanusi T, Zhao Y, et al. Porokeratosis with follicular involvement: report of three cases and review of literatures. [i]Int J Clin Exp Pathol.[/i] 2015;8(4):4248-4252

Yong AS, Singh M, Goulding JM, et al. Follicular porokeratosis of Mibelli on the buttocks. [i]Clin Exp Dermatol.[/i] 2009;34:43-45

Wang NS, Gruson LM, Kamino H. Facial Follicular Porokeratosis: A Case Report. [i]Am J Dermatopathol[/i]. 2010;32(7);720-722