Nepal Medical College and Teaching Hospital, Nepal
Title: Porokeratotic eccrine ostial and dermal duct nevus
Deeptara Pathak Thapa, an assistant professor in Dermatology has been trained in BPKIHS, Nepal one of the finest medical college in South East Asia. She is the post graduate coordinator in Dermatology. She has published articles on interesting topics in peer reviewed journals and is a reviewer for many international journals including IJD. She has not only presented papers in national and international conferences but has also organized annual national conference as the scientific committee chairman. She is an active member of International societies like ICD, SARAD, DSI, IADVL and National Society, SODVELON. Her interest is in cosmetic and clinical dermatology.
Porokeratotic eccrine ostial dermal duct nevus (PEODDN) is a rare variant of porokeratosis with characteristic histological feature of cornoid lamella, which is a thin column of parakeratotic cells with an absent or decreased underlying granular layer and dyskeratotic cells that involve acrosyringia. The cause is still unknown. Recently it has been proposed that it is caused by somatic connexin 26 mutations. PEODDN clinically presents as either multiple linear punctuate pits with comedo like plugs on palms and soles or keratotic plaques and papules that resemble linear VEN on other areas. It can present at the time of birth or early childhood or can have a late onset. It is mostly asymptomatic but can be associated with pruritus, hyperhydrosis or anhidrosis. There is rare case reports of PEODDN associated with conditions like hyperthyroidism and sensory polyneuropathy, breast hypoplasia, Bowen's disease etc. Treatment options as mentioned in literature are few. CO2 laser was found effective in few cases. Recently combination of Erbium/CO2 laser has been found effective. It is a rare disease with few case reports till date. Biopsy is essential to make diagnosis and there is a need to identify new treatment options to do justice to this cosmetically disfiguring condition with psychological impact.