GRANULAR PARAKERATOSIS
One of my associates, Patricia A. Vitale, diagnosed
this case. I had not heard of this entity, which goes to show it
pays to hire someone who knows more than you.
This clinical lesion is a manifestation of abnormal keratinization and usually occurs in the axilla, groin or other intertriginous area. Exceptional cases occur elsewhere. Deodorants or other topical agents have a suspected role in the intertriginous cases. One case from the back was dermatophyte related. Adults as well as children may be affected. The lesion in this case and in the literature responded completely to the application of a topical retinoid.
The parakeratotic stratum corneum is thickened and it contains keratohyalin granules. Inflammatory infiltrates and superficial vascular prominence have been present in some cases though not in this one.
This clinical lesion is a manifestation of abnormal keratinization and usually occurs in the axilla, groin or other intertriginous area. Exceptional cases occur elsewhere. Deodorants or other topical agents have a suspected role in the intertriginous cases. One case from the back was dermatophyte related. Adults as well as children may be affected. The lesion in this case and in the literature responded completely to the application of a topical retinoid.
The parakeratotic stratum corneum is thickened and it contains keratohyalin granules. Inflammatory infiltrates and superficial vascular prominence have been present in some cases though not in this one.
This is a biopsy of a brown, hyperkeratotic plaque from the axilla of a 27 year old female.
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Medium power view. The periodic acid-Schiff stained sections did not demonstrate fungi. |
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A
high power view. Keratohyalin granules are found in a thickened stratum
corneum over an intact stratum granulosum. These granules almost
obscure nuclear remnants in the left side of the picture. |
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Another high power view. Nuclear remnants as well as keratohyalin granules are demonstrated in the thickened stratum corneum. |
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