Axillary intertriginous granular parakeratosis responsive to topical calcipotriene and ammonium lactate
✍ Scribed by Michael E. Contreras; Lisa C. Gottfried; Ran H. Bang; Charles H. Palmer
- Book ID
- 104463915
- Publisher
- John Wiley and Sons
- Year
- 2003
- Tongue
- English
- Weight
- 104 KB
- Volume
- 42
- Category
- Article
- ISSN
- 0011-9059
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✦ Synopsis
A 70‐year‐old white man presented to our clinic with a 6–8‐month history of a pruritic, occasionally burning eruption in both axillae. He had been using the same deodorant for more than 1 year and denied any changes in laundry detergent, soaps, or shampoos. He also denied application of other topical products. On physical examination, there were slightly erythematous, lichenified plaques in both axillae, with more extensive involvement of the left side (Fig. 1). Histologic examination of a punch biopsy specimen from a left axillary plaque revealed hyperkeratosis with retention of nuclei and keratohyaline granules in the stratum corneum (Fig. 2). The stratum granulosum was slightly thickened, and the epidermis was mildly acanthotic. Patch tests of the patient's deodorant and shampoo were negative. The patient was advised to discontinue use of his deodorant. His right axilla was treated with topical calcipotriene, applied twice daily, and his left axilla was treated with topical 12% ammonium lactate, applied twice daily. One month later, the lesions in the right axilla had completely resolved. The left axilla was slightly improved, but still exhibited dusky erythematous plaques. After one additional month of treatment with ammonium lactate, the left axillary lesions completely resolved. A follow‐up examination 9 months later revealed no recurrence of the lesions in either axilla.
Erythematous, lichenified plaques in the axilla
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Photomicrograph of biopsy specimen showing keratohyaline granules in the stratum corneum (hematoxylin and eosin, × 200)
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