title: Development of disseminated superficial porokeratosis in a patient with complicated acute pancreatitis.
abstract: Porokeratosis is a group of hereditary or acquired diseases with abnormal epidermal keratinization. A 71-year-old man was admitted to the Surgery Department after an attack of acute pancreatitis complicated with pancreatic necrosis, which required surgical resection. Three weeks after the admission, the patient was observed by our Dermatology department with sudden onset of a generalized eruption of asymptomatic flat papules with a hyperkeratotic rim, sparing the face, palms, soles, and mucous membranes. A skin biopsy was performed at the border of a leg lesion, which disclosed the presence of cornoid lamella, confirming the clinical diagnosis of disseminated superficial porokeratosis (DSP). The skin eruption spontaneously subsided about one month after pancreatic resection. The late onset of DSP in our patient may represent a type of immunosuppression-induced porokeratosis. Possibly, the pathologic clone of keratinocytes for porokeratosis was present, but remained latent until there was a decrease in the immunological status. It is possible that this relative and transient state of immunosuppression was the result of the concurrent necrotizing pancreatitis. This case represents an unusually good outcome of DSP. To the authors best knowledge, this is the first case of DSP related to severe acute pancreatitis.
authors.affiliation: Department of Dermatology and Venereology, Hospital de São João EPE, Porto, Portugal.
authors.forename: O
authors.initials: O
authors.lastname: Ferreira
authors.forename: A F
authors.initials: AF
authors.lastname: Duarte
authors.forename: T
authors.initials: T
authors.lastname: Baudrier
authors.forename: A
authors.initials: A
authors.lastname: Mota
authors.forename: F
authors.initials: F
authors.lastname: Azevedo
mesh_terms: D000208:Acute Disease; D000368:Aged; D006801:Humans; D008297:Male; D009336:Necrosis; D010179:Pancreas / Q000473:pathology; D010180:Pancreatectomy; D010195:Pancreatitis / Q000473:pathology / Q000601:surgery*; D017499:Porokeratosis / Q000209:etiology* / Q000473:pathology* / Q000503:physiopathology; D011183:Postoperative Complications / Q000473:pathology* / Q000503:physiopathology; D012075:Remission, Spontaneous