Wikipedia

Granular parakeratosis

(Redirected from Intertriginous granular parakeratosis)

Granular parakeratosis, also known as axillary granular parakeratosis, intertriginous granular parakeratosis, and zombie patch is a cutaneous condition characterized by brownish-red keratotic papules that can coalesce into plaques.[1]

Granular parakeratosis
SpecialtyDermatology

Signs and symptoms edit

Granular parakeratosis frequently affects the folds and is characterized by erythema with variable degrees of hyperpigmentation. In certain people, it may also be significantly pruritic.[2]

Causes edit

The exact cause of granular parakeratosis is unclear.[2] The majority of reports elaborate links with skin maceration (due to occlusion,[3] warm surroundings,[4] perspiration, obesity, and recurrent washing[5]) or skin irritation from external chemicals (eg, antiperspirants, deodorants,[6] and zinc oxide). It appears to be a reactive process in the skin.[7] In case reports, exposure to benzalkonium chloride—a preservative and antiseptic used in a wide range of goods, such as medical treatments, laundry rinses, and wipes—has been suggested as a trigger.[8] There have also been reports of granular parakeratosis developing after using a depilatory lotion.[9]

Diagnosis edit

Granular parakeratosis skin biopsies reveal compact parakeratosis and hyperkeratosis in the stratum corneum.[10] The characteristic feature of the illness is the presence of basophilic keratohyalin granules in cells in the higher layers of the skin.[11] Most frequently, papillomatosis or an acanthotic pattern of thickening of the epidermis occurs with or without psoriasis.[10] There may also be a low-grade lymphohistiocytic infiltration.[3]

Treatment edit

After stopping the stimulant, some people heal on their own.[2] Oral isotretinoin,[12] antimicrobial medications, topical glucocorticoids,[13] tretinoin,[14] and vitamin D3 derivatives have also been reported to be beneficial.[15] Additionally, successful treatments with freezing, injections of botulinum toxin, and the combination of Nd: YAG and CO2 fractional laser therapy have been reported.[2]

See also edit

References edit

  1. ^ Rapini, Ronald P.; Bolognia, Jean L.; Jorizzo, Joseph L. (2007). Dermatology: 2-Volume Set. St. Louis: Mosby. ISBN 978-1-4160-2999-1.
  2. ^ a b c d Lin, Qingxia; Zhang, Dong; Ma, Weiyuan (2022). "Granular Parakeratosis: A Case Report". Clinical, Cosmetic and Investigational Dermatology. 15. Informa UK Limited: 1367–1370. doi:10.2147/ccid.s371558. ISSN 1178-7015. PMC 9297043. PMID 35874456.
  3. ^ a b Northcutt, Alan D.; Nelson, Donna M.; Tschen, Jaime A. (1991). "Axillary granular parakeratosis". Journal of the American Academy of Dermatology. 24 (4). Elsevier BV: 541–544. doi:10.1016/0190-9622(91)70078-g. ISSN 0190-9622. PMID 2033126.
  4. ^ G, Rodríguez (2002). "[Axillary granular parakeratosis]". Biomedica : Revista del Instituto Nacional de Salud. 22 (4). Biomedica: 519–523. doi:10.7705/biomedica.v22i4.1178. ISSN 0120-4157. PMID 12596449. Retrieved 2024-03-09.
  5. ^ Neri, Iria; Patrizi, Annalisa; Guerrini, Valentina; Fanti, Pier Alessandro (2003). "Granular Parakeratosis in a Child". Dermatology. 206 (2). S. Karger AG: 177–178. doi:10.1159/000068454. ISSN 1018-8665. PMID 12592091. S2CID 44618750.
  6. ^ Northcutt, Alan D.; Nelson, Donna M.; Tschen, Jaime A. (1991). "Axillary granular parakeratosis". Journal of the American Academy of Dermatology. 24 (4). Elsevier BV: 541–544. doi:10.1016/0190-9622(91)70078-g. ISSN 0190-9622. PMID 2033126.
  7. ^ Ding, Catherine Y.; Liu, Hannah; Khachemoune, Amor (2015-08-05). "Granular Parakeratosis: A Comprehensive Review and a Critical Reappraisal". American Journal of Clinical Dermatology. 16 (6). Springer Science and Business Media LLC: 495–500. doi:10.1007/s40257-015-0148-2. ISSN 1175-0561. PMID 26242230. S2CID 207482401.
  8. ^ Robinson, Aaron J; Foster, Rachael S; Halbert, Anne R; King, Emma; Orchard, David (2016-09-19). "Granular parakeratosis induced by benzalkonium chloride exposure from laundry rinse aids". Australasian Journal of Dermatology. 58 (3). Wiley: e138–e140. doi:10.1111/ajd.12551. hdl:11343/291746. ISSN 0004-8380. PMID 27641714. S2CID 263094709.
  9. ^ A, Samrao; M, Reis; G, Niedt; D, Rudikoff (2010). "Granular parakeratosis: response to calcipotriene and brief review of current therapeutic options". Skinmed. 8 (6): 357–359. ISSN 1540-9740. PMID 21413654. Retrieved 2024-03-09.
  10. ^ a b "UpToDate". UpToDate. Retrieved 2024-03-09.
  11. ^ Ip, Ken Hiu-Kan; Li, Angela (2022-01-30). "Clinical features, histology, and treatment outcomes of granular parakeratosis: a systematic review". International Journal of Dermatology. 61 (8). Wiley: 973–978. doi:10.1111/ijd.16107. ISSN 0011-9059. PMC 9546368. PMID 35094385.
  12. ^ Webster, Cynthia G.; Resnik, Kenneth S.; Webster, Guy F. (1997). "Axillary granular parakeratosis: Response to isotretinoin". Journal of the American Academy of Dermatology. 37 (5). Elsevier BV: 789–790. doi:10.1016/s0190-9622(97)70119-1. ISSN 0190-9622. PMID 9366832.
  13. ^ Chamberlain, A. J.; Tam, M. M. (2003). "Intertriginous granular parakeratosis responsive to potent topical corticosteroids". Clinical and Experimental Dermatology. 28 (1). Oxford University Press (OUP): 50–52. doi:10.1046/j.1365-2230.2003.01159.x. ISSN 0307-6938. PMID 12558631. S2CID 33504233.
  14. ^ Brown, Sonya K.; Heilman, Edward R. (2002). "Granular parakeratosis: Resolution with topical tretinoin". Journal of the American Academy of Dermatology. 47 (5). Elsevier BV: S279–S280. doi:10.1067/mjd.2002.109252. ISSN 0190-9622. PMID 12399751.
  15. ^ Contreras, Michael E.; Gottfried, Lisa C.; Bang, Ran H.; Palmer, Charles H. (2003). "Axillary intertriginous granular parakeratosis responsive to topical calcipotriene and ammonium lactate". International Journal of Dermatology. 42 (5). Wiley: 382–383. doi:10.1046/j.1365-4362.2003.01722.x. ISSN 0011-9059. PMID 12755978. S2CID 9695747.

Further reading edit

External links edit

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