We reviewed the charts of 20 patients diagnosed with PK by skin biopsy at our Department of Dermatology from January 2001 to December 2006. Of these 20 patients, 9 patients with a history of renal transplantation were included, and their clinical characteristics and skin biopsy slides were reviewed. During this period, 298 renal transplan­tations were conducted at our hospital.

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INTRODUCTION

Porokeratosis (PK) is a specific keratinization disorder, and is histologically characterized by the presence of a cornoid lamella, a thin column of closely stacked, parakeratotic cells that extend through the stratum corneum. Clinically, the basic lesion is sharply demarcated and hyperkeratotic, and may be annular with central linear or punctate atrophy. Five clinical variants are recognized, namely, PK Mibelli, PK palmaris et plantaris disseminata, linear PK, punctate PK, and disseminated superficial PK (DSP) and disseminated superficial actinic PK (DSAP).

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The pathogenesis of eruptive collagenoma is unknown. Uitto et al showed that collagenoma almost exclusively consists of type I collagen and the underlying defect seemed to be a reduced pro­duction of collagenase in that location, and therefore a decreased local degradation of collagen. And some reports that the growth of collagenoma was influenced during pregnancy or puberty imply that hormone may be involved in the pathogenesis of this disorder.

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Connective tissue nevi of the skin are acquired hamartomatous lesions consisting predominantly of one of the components of the extracellular matrix, namely collagen, elastin, or glycosaminoglycans. Among these, collagenomas are connective tissue nevi composed predominantly of collagen. They have been classified as either inherited or acquired. Inherited collagenomas include familial cutaneous collagenoma and Shagreen patch of tuberous sclero­sis. Acquired collagenomas contain isolated colla- genoma and eruptive collagenoma depending on the number of lesions but they cannot be differentiated clinically.

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A 16-year-old boy presented with numerous asymptomatic papules on the left calf. The lesion first appeared at the age of 10 years and had been slowly increasing in number and size. He denied previous skin eruptions or trauma to the areas where the papules developed. He had no other significant problems in health and there was no family history of similar disorders. Physical examina­tion revealed multiple slightly raised, yellowish grouped papules on the left calf (Fig. 1). The papules measured 3 to 5 mm in diameter. The initial clinical diagnosis was sebaceous hyperplasia, xanthoma or collagen disorders. The histological examination revealed unremarkable epidermis and slightly homo­genized condensed collagen and decreased elastic fibers in the dermis (Fig. 2A). …Read the rest of this article

INTRODUCTION

Eruptive collagenoma is a rare acquired con­nective tissue hamartoma consisting predominantly of collagen without family history. Eruptive collagenoma has been described as multiple small papules with areas of decreased or degenerated elastic fibers, usually on the trunk and arms. …Read the rest of this article

The double-bladed scalpel consists of a handle, blade holder and metal-spacers, as is shown on Fig. 2; this instrument can hold two blades and the distance between the two blades can be adjusted. This device was described in 1977 by Coiffman, and it was originally developed for harvesting strip grafts from the scalp for hair transplantation. Up to 16 parallel blades have been placed on a single knife for this purpose. The double-bladed scalpel has been employed for scar removal, staged excision of lentigo maligna melanoma with permanent vertical section margin control and excision of small basal cell carcinoma.

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