Granular parakeratosis

José M Martín, Isabel Pinazo, Inmaculada Molina, Carlos Monteagudo, Guillermo Villalón, Esperanza Jordá
International Journal of Dermatology 2008, 47 (7): 707-8
A healthy 62-year-old woman was referred to our dermatology department with a 1-month history of a pruritic axillary eruption. On examination, multiple erythematous and brownish hyperkeratotic papules were seen in both axillae. Some of these lesions coalesced into plaques, with small areas of sparing, and a background erythematous color was also found in the axillary vaults (Fig. 1). There was no involvement of other intertriginous sites and there were no associated systemic symptoms. The patient was not obese. The patient had removed the hair from her axillae with wax 3 weeks before the development of the eruption. Moreover, she had changed her antiperspirant 1 week before the onset of the lesions. A cutaneous biopsy for histologic analysis was performed. Histologically, the stratum corneum was thickened, with persistent nuclei together with countless small basophilic granules. The granular layer was preserved and, in some areas, hypergranulosis was found (Fig. 2). These findings were characteristic of granular parakeratosis. The cutaneous lesions resolved completely after 1 week of treatment with topical betamethasone dipropionate and gentamicin sulfate (twice daily). The patient was urged to discontinue her use of deodorants.

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