Porokeratosis in a Patient With Hepatitis of Unclear Etiology

Porokeratosis is hypothesized to be an inherited autosomal dominant disorder with variable penetrance. It has been linked to ultraviolet (UV) radiation in genetically predisposed individuals, to antibody-related autoimmune disease treated with systemic steroids, and to other immunosuppressive states including chronic liver disease. The authors describe an unusual case of a patient with newonset hepatitis of unclear etiology who developed concomitant erythematous annular plaques with atrophic centers and elevated scaling borders on the lower extremities. The histological features of these lesions were consistent with disseminated superficial porokeratosis (DSP). The authors present this patient and a review of the literature to support the direct pathological link between hepatitis and DSP, irrespective of the state of the immune system. Further research would be helpful in clarifying the pathogenesis of porokeratoses in patients with hepatic dysfunction.