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Porokeratoma - Treatment

Discussion in 'General Issues and Discussion Forum' started by timbogates, Dec 20, 2011.

  1. timbogates

    timbogates Member

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    What is recommended as the best way to treat a Porokeratoma? It highly resembles a plantar wart but it is not.

    Salicylic Acid pads? Cryotreatment? Surgery only? It is about 3-4 mm in diameter near the 5th metatarsal area?

    Do they return like a plantar wart? If so what is the percentage of the time?

  2. gdockdockery

    gdockdockery Member

    I like to treat keratomas and other punctate keratotic lesions with sublesional injections of 4% alcohol. I have been successfully using this technique for almost 30 years and I have written about it several times. Everyone has a treatment that they prefer, whether it is acid, cryotherapy, debride & pad, surgery, etc. and this is my preferred approach.

    Dockery GL and Nilson RZ: Intralesional Injections. In, Dockery GL (ed.): Dermatology of the Lower Extremities, Clinics Pod. Med. Surg., W.B. Saunders Co., Philadelphia, Vol. 3, 3: July 1986, pp. 473-486.

    Dockery GL: Evaluation and Treatment of Metatarsalgia and Keratotic Disorders. Ch. 12, In, Myerson MS (ed): Foot and Ankle Disorders, W. B. Saunders Co., Philadelphia, 1999, pp 359-377.

    Dockery GL, Crawford ME: Evaluation and Management of Keratotic Disorders of the Foot. Atlas of Office Procedures. W. B. Saunders Co., Philadelphia, 3:1-21, 2000.

    Dockery GL: When Injection Therapy Can Help Relieve Painful Lesions. Podiatry Today. 15 (6):30-36, June 2002. [http://www.podiatrytoday.com/article/468]

    Dockery GL: Dilute Alcohol Injections for Nerve Conditions and Keratotic Lesions of the Foot. Podiatry Management. p.117-126, January 2004.
  3. drsarbes

    drsarbes Well-Known Member

    I usually reduce as deep as I can without anesthesia then have the patient apply 10% Formalin twice per day for two weeks. When they return I will remove the callous that has formed and frequently this simple technique will eradicate the poro.

    When it does not, (or if I'm running on time) I anesthetize the area, curette and apply 88% phenol. This almost always works.

  4. blinda

    blinda MVP

    Hi Gary!

    Great to see you posting on the Arena (Hope you remember me, we met at the FIP congress in Amsterdam last year). Please continue to do so, your expertise in cutaneous disorders would be most welcome here.

    Many thanks for the refs. Just what I`ve been looking for :drinks

    Belinda Longhurst
  5. blinda

    blinda MVP

    Hi again Tim,

    Would love to be able to offer advice on this case (with which you have frequently started threads on over the past year ;)). However, I would suggest that it would be courteous of you to answer the original questions;

    Hey, life is too short to be skirting around. Let`s start again. Cards on the table, Tim. Are you a podiatry student or `is this your foot` as my honourable friend Mr Isaacs so eloquently pointed out?


    Have a great 2012 Tim :drinks


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