Granular parakeratosis: a case report and literature review

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<jats:p><jats:bold>Background: </jats:bold> Granular parakeratosis is suspected to result from an error in epidermal differentiation, leading to variably pruritic, hyperpigmented‐to‐erythematous patches and plaques. Characteristic histopathologic features include a thickened stratum corneum, compact parakeratosis with retention of keratohyalin granules, vascular proliferation, and ectasia. The pathogenesis of this entity is uncertain.</jats:p><jats:p><jats:bold>Methods: </jats:bold> We present a case of axillary granular parakeratosis and review the literature.</jats:p><jats:p><jats:bold>Results: </jats:bold> The lesion showed a thickened stratum corneum with compact parakeratosis, slight epidermal hyperplasia, and a sparse perivascular lymphohistiocytic infiltrate. Keratohyalin granules were diffusely present within the parakeratotic stratum corneum, and the retained granular layer showed focal vacuolization.</jats:p><jats:p><jats:bold>Conclusions: </jats:bold> Granular parakeratosis is a rare form of parakeratosis most often seen in the axilla, although other intertriginous areas may be affected. Unique histopathologic findings allow for a specific diagnosis to be made. Although an irritant contact reaction appears causative, mechanical irritation may also play a role in inducing these skin changes.</jats:p>

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