SHM Converge Scientific Abstract ePoster Gallery-Late-Onset Disseminated Superficial Actinic Porokeratosis in an Elderly Women

Pdf Summary

This case report describes disseminated superficial actinic porokeratosis (DSAP), a rare and common variant of porokeratosis that typically appears on sun-exposed skin as pink to brown papules or annular plaques with a raised, scaly border. The authors present a 60-year-old woman with type 2 diabetes, hypertension, and hyperlipidemia who developed scaly pink macules with collarette scaling on both lower legs and forearms.  <br /><br />She was referred to dermatology and underwent a skin biopsy of the right lower extremity, which showed benign skin with focal parakeratosis and no evidence of malignancy or fungal infection. Based on the clinical and biopsy findings, she was diagnosed with DSAP and treated with topical 5-fluorouracil twice daily for two weeks. She was also advised to use photoprotective measures such as sunscreen and long sleeves.  <br /><br />The discussion emphasizes that DSAP is important to recognize because skin conditions are common in primary care, yet DSAP may be overlooked. Diagnosis is usually clinical, often supported by dermatoscopy. The condition has been associated with immunosuppression, chronic liver disease, HIV, autoimmune disease, and ultraviolet exposure. Although often benign, DSAP carries a risk of malignant transformation, most commonly to squamous cell carcinoma.  <br /><br />Treatment options include topical 5-fluorouracil, diclofenac, cryotherapy, imiquimod, photodynamic therapy, retinoids, vitamin D3 analogs, and topical lovastatin, but management is often difficult and not well standardized. The report highlights the importance of early recognition and sun protection in managing DSAP.

Asset Subtitle

Sagar Patel

Meta Tag

Author List Jane Bridges, Margaret Beliveau, Sagar Patel

Category Clinical Vignettes

Concept Disseminated Superficial Actinic Porokeratosis

Concept Porokeratosis

Concept Ultraviolet Exposure

Concept Squamous Cell Carcinoma

Concept Scaly Macule

Distinguished Non-Finalist

Presenter Organization Indiana University Southwest Internal Medicine

Presenting Author Sagar Patel

Track Adult

Keywords

disseminated superficial actinic porokeratosis

DSAP

porokeratosis

sun-exposed skin

collarette scaling

skin biopsy

topical 5-fluorouracil

photoprotection

squamous cell carcinoma

dermatology

Disseminated Superficial Actinic Porokeratosis

Porokeratosis

Ultraviolet Exposure

Squamous Cell Carcinoma

Scaly Macule