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A Journal on Dermatology and Sexually Transmitted Diseases

Official Journal of the Italian Society of Dermatology and Sexually Transmitted Diseases
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Giornale Italiano di Dermatologia e Venereologia 2000 December;135(6):703-6

language: Italian

Porokeratosis and immunosuppression

Patrizi A., Morrone P., D’Acunto C., Raone B., Varotti E. *

Università degli Studi - Bologna Dipartimento di Medicina Clinica Specialistica e Sperimentale Sezione di Clinica Dermatologica (Direttore: Prof. C. Varotti)
* Università degli Studi - Ferrara Dipartimento di Medicina Clinica e Sperimentale Sezione di Dermatologia (Direttore: Prof. A. Califano)


Porokeratosis is a disorder of the keratization of the epidermis, of unknown cause. Various clinical forms have been described which, however, have a common histopathological marker: cornoid lamellae. The most recent classification of porokeratosis made by Shamroth et al. in 1997 considers the form associated with immunosuppression as a distinct variant which is present in most cases with the clinical features of superficial disseminated porokeratosis, although the classic Mibelli variant has rarely been observed. Two cases of porokeratosis associated with immunosuppression are reported. A 55-year-old man affected by idiopathic myelofibrosis has been treated with methyl prednisone 80-100 mg/die for 6 months. A 39-year-old man was given a cadaver renal transplant 12 years before our observation and is under treatment with prednisone 15mg/die and azathioprine 100 mg/die. These 2 patients presented the first one 2 lesions located one on the dorsum of the right hand and one on the right thigh, the second patient a plaque located on the right foot. There are various hypotheses about the correlation between porokeratosis and immunosuppression. Some authors believe that the Langerhans cells play an important role. It has been hypothesized that both the reduction in number and the loss of the immunosurveillance function brought about by these cells causes an uncontrolled proliferation of genetically changed clones of keratinocytes leading to the typical lesions of porokeratosis.

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