Darier disease is an autosomal dominant manner, with complete penetrance and variable expressivity. The condition is caused by mutations in the ATP2A2 gene, which encodes SERCA2. Family history is often overlooked due to subtle clinical presentations and presentation is common at around 20 years of age.

Case Report:This is the case of a 79-year-old elderly female who presented with a three year history of intensely pruritic erythematous hyperkeratotic papules on the face, trunk, and all extremities aggravated by heat and sweating. She reported of similar skin lesions seen on her father and brother, however they were undiagnosed and not treated. Multiple medications, including Prednisone, topical steroids, and antibiotics, provided temporary relief. Skin punch biopsy was done which revealed Acantholytic acanthoma consistent with Darier’s disease. CBC, SGPT, SGOT, Alkaline Phosphatase, BUN, Creatinine, Lipid Profile, FBS were requested and she was managed with topical corticosteroids, isotretinoin, Urea 10% lotion, and oral anti-histamines.

Darier disease is an autosomal dominant genodermatosis caused by mutations in the ATP2A2 gene, often presenting during puberty with chronic symptoms like hyperkeratotic lesions and nail abnormalities. Diagnosis relies on clinical and histopathologic correlation, aided by family history, though variable expressivity can complicate it. Coexisting infections must be evaluated due to potential morbidity. Treatment options include systemic retinoids, immunomodulators, and topical therapies like retinoids and calcineurin inhibitors. Personalized therapies have shown promise. Patient education on trigger avoidance and genetic counseling is crucial for managing recurrence risk, while life expectancy remains comparable to the general population.

BACKGROUND

Seborrheic keratosis is a common benign skin tumor treated with invasive methods like electrodessication, cryotherapy, or surgery. Topical therapy with trichloroacetic acid (TCA) may be a cheaper, non-invasive alternative with less complications. While TCA has been studied for other skin conditions, more research is needed on its use for seborrheic keratosis.

To compare the safety and efficacy of one time application of 80% TCA peel to 65% TCA peel in the clearance of raised seborrheic keratosis in Filipino patients.

One hundred one patients were randomized to either 80% or 65% TCA groups. Each participant underwent one session of treatment and was followed up after a month. Pre- and post-test size and thickness of lesions were compared between groups.

Based on Physician’s Lesion Assessment (PLA), both concentrations of TCA achieved high treatment success (TCA80: 66.7%, TCA65: 68%, p-value 0.89). A similar trend was observed based on Subject’s Self-Assessment (TCA80: 74%, TCA65: 74.5%, p-value 0.95). Similar reductions in lesion size and thickness were observed in both concentrations. In terms of safety, pain, pruritus, and erythema were mostly observed during and immediately after treatment, with little to no adverse events observed after 1 month in both groups.

One time application of either 80% or 65% TCA is effective in decreasing the size and thickness of seborrheic keratosis with little to no complications 1 month post- treatment. Both concentrations were safe, causing minimal and non-persistent pain, pruritus, and erythema immediately after application.

Intermetatarsal coalition (IC) is very rare; although few cases have been reported in foreign orthopedic journals, these have not originated in our country. We report the case of a 20-year-old man who complained of pain in the left forefoot only during long distance running (3 km). On examination, his foot shape, skin appearance, and gait were normal, with no plantar keratosis; however, the radiograph revealed coalition between the fourth and fifth metatarsals. Surgical excision was performed. In the histopathologic study, fibrous coalition was confirmed. This paper reports an uncommon case involving surgical excision of IC in the military service, involving active sport activity.
Foot ; Gait ; Humans ; Keratosis ; Metatarsal Bones ; Military Personnel ; Orthopedics ; Running ; Skin ; Sports ; Synostosis ; Young Adult

Background: Seborrheic keratosis is a benign skin tumor removed through electrodessication, cryotherapy, or surgery. Alternative options may be beneficial to patients with contraindications to standard treatment, or those who prefer a non-invasive approach. Objectives: To determine the effectiveness and safety of topical medications on seborrheic keratosis in the clearance of lesions, compared to placebo or standard therapy. Methods: Studies involving seborrheic keratosis treated with any topical medication, compared to cryotherapy, electrodessication or placebo were obtained from MEDLINE, HERDIN, and Cochrane electronic databases from 1990 to June 2018. Results: The search strategy yielded sixty articles. Nine publications (two randomized controlled trials, two non-randomized controlled trials, three cohort studies, two case reports) covering twelve medications (hydrogen peroxide, tacalcitol, calcipotriol, maxacalcitol, ammonium lactate, tazarotene, imiquimod, trichloroacetic acid, urea, nitric-zinc oxide, potassium dobesilate, 5-fluorouracil) were identified. The analysis showed that hydrogen peroxide 40% presented the highest level of evidence and was significantly more effective in the clearance of lesions compared to placebo. Conclusion Most of the treatments reviewed resulted in good to excellent lesion clearance, with a few well-tolerated minor adverse events. Topical therapy is a viable option; however, the level of evidence is low. Standard invasive therapy remains to be the more acceptable modality.
Keratosis, Seborrheic ; Systematic Review

No abstract available.
Actins ; Keratosis, Actinic ; Prevalence

BACKGROUND: The incidence of cutaneous malignant tumors and premalignant lesions has recently increased worldwide. However, studies investigating the incidence and clinical manifestations of cutaneous malignant tumors and premalignant lesions in Korea are rare, especially in southeastern Gyeonggi-do Province. OBJECTIVE: To analyze the recent trends in the incidence of cutaneous malignant tumors and premalignant lesions in southeastern Gyeonggi-do Province. METHODS: We retrospectively reviewed 451 cases of cutaneous malignant tumors and 455 cases of premalignant lesions from 2006 to 2016. RESULTS: The average annual incidence rates of cutaneous malignant tumors and premalignant lesions among the total number of outpatients was 0.84% and 0.85%, respectively, and both these rates increased significantly over time. Basal cell carcinoma was most commonly diagnosed cutaneous malignant tumor (50.8%), followed by squamous cell carcinoma (24.6%), malignant melanoma (8.2%), and metastatic carcinoma (5.1%). The most common premalignant lesion was actinic keratosis (60.0%). The mean age of the patients with cutaneous malignant tumors and premalignant lesions was 68.8 years and 70.8 years, respectively. The ratio of male to female patients was 1 : 1.19 for cutaneous malignant tumors and 1 : 2.01 for premalignant lesions. The face was the most common site for both cutaneous malignant tumors and premalignant lesions (at 71.9% and 75.8%, respectively). CONCLUSION: This retrospective study provided data about the incidence and clinical patterns of cutaneous malignant tumors and premalignant lesions among patients in southeastern Gyeonggi-do Province.
Carcinoma, Basal Cell ; Carcinoma, Squamous Cell ; Female ; Gyeonggi-do* ; Humans ; Incidence ; Keratosis, Actinic ; Korea ; Male ; Melanoma ; Outpatients ; Retrospective Studies ; Statistics as Topic*

Ingenol mebutate (IM) is approved for the treatment of actinic keratosis and induces cell death in precancerous lesions. The efficacy of IM in the treatment of genital warts was investigated in a therapy-refractory patient. The 74-year-old male was treated with IM gel for three consecutive days. Treatment course and efficacy were evaluated by clinical inspection and non-invasive diagnostics namely optical coherence tomography (OCT) and reflectance confocal microscopy (RCM). Within 24 to 48 hours IM induced a strong local inflammatory reaction. One week later a complete response was observed. OCT and RCM showed a strong reaction after treatment with erosions, swelling of cells, and a subepidermal dark band in representative lesions. IM has the advantage of a short treatment period in contrast to other topical treatments and shows a promising clinical outcome. Larger studies are needed to validate the data.
Aged ; Cell Death ; Condylomata Acuminata ; Humans ; Keratosis, Actinic ; Male ; Microscopy ; Microscopy, Confocal ; Tomography, Optical Coherence

No abstract available.
Carcinoma, Basal Cell ; Keratosis, Seborrheic

No abstract available.
Asian Continental Ancestry Group ; Humans ; Keratosis ; Male

The rate of malignant transformation in porokeratosis (PK) lesions is approximately 7.5%, and linear PK demonstrates the highest rate of malignancy. An 83-year-old woman presented with a rapidly enlarging mass on her left arm. Variably sized erythematous scaly patches were scattered across the left half of her trunk and arm. Additionally, generalized variably sized brownish annular patches with a hyperkeratotic outer ring were observed on her face, trunk and bilateral arms. A skin biopsy was performed on 3 lesions-a yellowish to erythematous appearing mass, an erythematous scaly patch, and a brownish annular patch. Histopathological evaluation of these 3 lesions revealed squamous cell carcinoma, actinic keratosis, and PK, respectively. The final diagnosis was disseminated superficial PK with linear PK on the left side of the body, and actinic keratosis and squamous cell carcinoma confined to the linear PK lesions. We report a case which represents the progressive and stepwise malignant transformation of PK into squamous cell carcinoma.
Aged, 80 and over ; Arm ; Biopsy ; Carcinoma, Squamous Cell ; Diagnosis ; Female ; Humans ; Keratosis, Actinic ; Porokeratosis* ; Skin