Keratoacanthoma and PUVA Keratoses in a Vitiligo Patient Following Oral Psoralen Photochemotherapy (PUVA).
- Author:
Seong Hyun KIM
1
;
Min Jung KANG
;
So Yun CHO
;
Kyu Kwang WHANG
;
Jeong Hee HAHM
Author Information
1. Department of Dermatology Ewha Womans University, Seoul, Korea.
- Publication Type:Case Report
- Keywords:
Vitiligo;
PUVA;
PUVA keratosis;
Keratoacanthoma
- MeSH:
Biopsy;
Diagnosis;
DNA Damage;
Down-Regulation;
Female;
Ficusin*;
Foot;
Genes, Tumor Suppressor;
Hand;
Humans;
Immunosuppression;
Keratoacanthoma*;
Keratosis*;
Middle Aged;
Photochemotherapy*;
PUVA Therapy;
Skin;
Skin Neoplasms;
Sunlight;
Vitiligo*
- From:Korean Journal of Dermatology
2000;38(9):1234-1238
- CountryRepublic of Korea
- Language:Korean
-
Abstract:
Systemic PUVA therapy can produce various acute reactions and potential long-term damage including benign and malignant skin tumors. Obviously the risk is related to DNA damage, but PUVA-induced down-regulation of immune responses may play an additional role. Keratoacanthoma is etiologically related to sunlight and immunosuppression. PUVA keratoses are raised warty papules with a broad base and a diameter of several millimeters to 1 centimeter, and they are associated with an increased risk of nonmelanoma skin cancer. We report a case of solitary keratoacanthoma and multiple PUVA keratoses all developing in vitiliginous areas in a patient receiving long-term, high-dose PUVA therapy for generalized vitiligo. A 57-year-old Korean female, who had undergone intermittent systemic PUVA therapy for 11 years, noted multiple asymptomatic, yellowish, hyperkeratotic papules on the dorsa of hands and feet 1 year previously, and a bean-sized raised painful nodule filled with keratin plug on the dorsum of right hand 1 month previously. Skin biopsy confirmed the diagnoses of PUVA keratoses and keratoacanthoma, respectively. PCR-SSCP analysis revealed no mutation of p53 tumor suppressor gene in this case.
