How would you diagnose these lesions?
A 46-year-old male presented for evaluation of lesions on the superior gluteal cleft that he could palpate but were asymptomatic. He was otherwise healthy and there was no exposure history or history of trauma.
How would you diagnose this patient?
A. Herpes simplex
B. Human papillomavirus
C. Lichen planus
D. Psoriasis
E. Porokeratoses
(Answer and discussion on next page)
Answer: Porokeratoses
A biopsy revealed the rare variant of porokeratosis ptychotropica. As of 2014, there were less than 25 reports in the literature.1 A biopsy will confirm the diagnosis. Multiple lesions can be removed by liquid nitrogen or via a shave biopsy as they typically do not respond to topical medications.
Reference:
1. D’souza P, Dhali TK, Arora S, et al. Porokeratosis ptychotropica: a rare variant of porokeratosis. Dermatol Online J. 2014;20(6).