What is disseminated superficial actinic porokeratosis? Disseminated superficial actinic porokeratosis, or DSAP, is an inherited keratinisation disorder that causes discrete dry patches on the arms and legs. DSAP is a special type of inherited 'sunspot".
Actinic keratosis. L57.0 is a billable/specific ICD-10-CM code that can be used to indicate a diagnosis for reimbursement purposes. The 2021 edition of ICD-10-CM L57.0 became effective on October 1, 2020. This is the American ICD-10-CM version of L57.0 - other international versions of ICD-10 L57.0 may differ.
L57.0 is a billable/specific ICD-10-CM code that can be used to indicate a diagnosis for reimbursement purposes. The 2018/2019 edition of ICD-10-CM L57.0 became effective on October 1, 2018.
What is porokeratosis? Porokeratosis is a group of skin conditions in which there is abnormal keratinisation. The skin lesions that result are dry and atrophic, with a well-defined ridge-like hyperkeratotic border called a cornoid lamella (best seen on dermoscopy).
Porokeratosis classifies to Q82. 8 in the ICD-10 index, so that is the correct code if this is the documented diagnosis - no need to make any assumptions, and the type of visit does not affect the coding.
Disseminated superficial actinic porokeratosis (DSAP) is a skin condition that causes dry, scaly patches.[8488] Symptoms include a large number of small, brownish patches with a distinctive border, found most commonly on sun-exposed areas of the skin (particularly the lower arms and legs).[8488][8489] DSAP usually ...
Disseminated superficial actinic porokeratosis, or DSAP, is an inherited keratinisation disorder that causes discrete dry patches on the arms and legs. DSAP is a special type of inherited 'sunspot". The name porokeratosis means scaly pore and is a misnomer as porokeratosis is not related to pores.
Porokeratosis is a clonal disorder of keratinization characterized by one or more atrophic patches surrounded by a clinically and histologically distinctive hyperkeratotic ridgelike border called the cornoid lamella.
It is sometimes confused with actinic keratosis which is also caused by sun exposure (See Patient Information Leaflet on Actinic Keratoses); however, actinic keratosis is more likely to arise on the face and hands. DSAP is twice as likely to develop in women compared with men and is more common in lighter skin type.
Treatment options include the following.Topical diclofenac. Diclofenac is an NSAID that inhibits COX-2. ... Ingenol mebutate. ... Topical vitamin D analog. ... 5-fluorouracil. ... Imiquimod. ... Photodynamic therapy. ... Retinoids. ... Cryotherapy and other.More items...
The development of disseminated superficial porokeratosis is occasionally observed in association with renal transplant, autoimmune diseases and various hematological disorders, suggesting a certain immunosuppression may trigger a widespread abnormal keratinization.
DSAPAcronymDefinitionDSAPDynamic Situation Assessment and PredictionDSAPDefense Security Assistance ProgramDSAPData Service Access PointDSAPDNA Sequence Analysis Program11 more rows
Porokeratosis is a skin condition which appears as raised brown bumps that may expand into scaly patches. They often have raised rings around the spots.
Porokeratosis is considered a premalignant condition, as all its variants have a potential for malignant transformation. The most common cancer is squamous cell carcinoma followed by basal cell carcinoma.
Porokeratosis is a rare, acquired or inherited disorder of keratinization characterized by one or more atrophic macules or patches, each surrounded by a distinctive hyperkeratotic, ridge-like border called "cornoid lamella" (picture 1D) [1,2]. Multiple clinical variants of porokeratosis exist.
DSAP can be difficult to manage; however, treatment may include topical imiquimod and fluorouracil, vitamin D3 analogues, topical and oral retinoids, topical cholesterol/lovastatin, cryotherapy, excision, curettage, laser ablation, photodynamic therapy and radiation therapy.
Disseminated superficial actinic porokeratosis (DSAP) prevalence is not precisely known, although DSAP is the most common form of porokeratosis. It is more frequently seen in women, probably because they more readily seek advice for cosmetic concerns.
The disease usually starts during the third to fourth decade of life (only rarely during childhood). DSAP is characterized by several small (0.5-1 cm), round, pink-brownish plaques, surrounded by a distinctive keratotic rim, corresponding microscopically to the cornoid lamella. They are painless, but pruritus is reported in one third of patients.
Mutations in the mevalonate kinase ( MVK) gene, located to chromosome 12q24, have been found in up to one third of DSAP cases. MVK encodes an enzyme in the mevalonate pathway, which is thought to be crucial for the biosynthesis of cholesterol and isoprenoid as well as the regulation of calcium-induced keratinocyte differentiation.
Histopathological examination of a cutaneous biopsy confirms the clinical diagnosis of DSAP. The characteristic feature is the presence of a cornoid lamella, i.e. a vertical stack of parakeratotic corneocytes within the horny layer, seated on a shallow depression of the underlying epidermis that is devoid of a granular layer.
Differential diagnoses include (pre)neoplastic or hyperplastic keratotic skin lesions as well as other forms of porokeratosis, such as porokeratosis of Mibelli or superficial disseminated porokeratosis (similar to DSAP but not triggered by sunlight).
DSAP often follows an autosomal dominant pattern of inheritance, but sporadic cases have also been reported.
There is no standard treatment for DSAP. Topical imiquimod 5% cream, topical 5-fluorouracil (5-FU) and topical vitamin D-analogues (tacalcitol, calcipotriol) have shown to be beneficial in treating the lesions of DSAP in some patients. Cryotherapy, electrodessication, laser ablation and photodynamic therapy have been tested with varying results.
A precancerous lesion of the skin composed of atypical keratinocytes. It is characterized by the presence of thick, scaly patches of skin. Several histologic variants have been described, including atrophic, acantholytic, and hyperkeratotic variants. A thick, scaly patch of skin that may become cancer.
The 2022 edition of ICD-10-CM L57.0 became effective on October 1, 2021.
Skin changes due to chronic exposure to nonionizing radiation. Approximate Synonyms. Keratosis. Stucco keratosis. Clinical Information. (ak-tin-ik ker-a-toe-sis) a precancerous condition of thick, scaly patches of skin. A precancerous lesion of the skin composed of atypical keratinocytes.
Background: Disseminated superficial actinic porokeratosis (DSAP) is a rare dermatologic disorder of the epidermis. Often misdiagnosed as chronic UV-damage or actinic keratoses, patients are treated for years with different therapeutic options with little success. Current treatment options include imiquimod, ingenol mebutate, cryosurgery, photodynamic therapy and topical or systemic therapy with retinoids. Since those approaches show only little success or come along with major side effects, therapeutic alternatives are strongly requested. Methods: We report a series of five female patients with history of DSAP that were successfully treated with chemical peels. Results: All patients suffered from the disease for 14.4 years on average and all were refractory to at least two therapeutic options, mostly imiquimod and topical tretinoin. Patients were treated with glycolic acid 50% and salicylic acid 25% in a two-layer-technique. After a mean of three cycles every 6 weeks a clear reduction in lesion was assessed by physicians. Patients were highly satisfied with outcome and rare occurrence of side effects as assessed by TSQM questionnaire. Conclusion: Chemical peels are safe and well tolerated treatment options for patients with refractory porokeratosis. As characteristic for chronic diseases, frequent repetition of treatment is needed in order to control disease activity.
Conclusion: Chemical peels are safe and well tolerated treatment options for patients with refractory porokeratosis. As characteristic for chronic diseases, frequent repetition of treatment is needed in order to control disease activity. Keywords: Porokeratosis; chemical peels; patient-reported outcome; rare disease.
Each porokeratosis lesion has a characteristic ridge on its border and a central furrow. Their size, onset and distribution depends on the specific type of porokeratosis.
The diagnosis of porokeratosis is usually made clinic ally, often with the help of dermoscopy, but sometimes a biopsy is needed. The biopsy should include the raised edge of the lesion. The pathology of porokeratosis is very distinct, but it may be necessary to point out the clinical features for the pathologist to find a cornoid lamella within the pathological specimen.
Porokeratosis is a group of skin conditions in which there is abnormal keratinisation. The skin lesions that result are dry and atrophic, with a well-defined ridge-like hyperkeratotic border called a cornoid lamella (best seen on dermoscopy) [1].
The main complication of porokeratosis is a skin cancer, which can develop within a porokeratosis lesion. This may be either a basal cell carcinoma or squamous cell carcinoma, and is more likely to occur in older adults [6]. Porokeratosis should be monitored for malignancy.
The cornoid lamella in porokeratosis is due to an expanding clonal proliferation of unusual keratinocytes, which is thought to be due genetic mutation [4]. In some types of porokeratosis, a family history is present, consistent with a genetic predisposition [3].
Porokeratosis of Mantoux (also known as porokeratosis palmaris et plantaris disseminata, which is a form of punctate palmoplantar keratoderma in which there are scaly red-brown annular patches on the palms and soles that later spread to the limbs and trunk) Porokeratotic eccrine ostial and dermal duct naevus.
There is no known cure for porokeratosis and treatment is generally disappointing. However, the appearance may improve with the following measures: