What is your treatment algorithm for managing porokeratosis?

Porokeratoses do not necessarily require treatment unless desired by the patient for symptomatic or cosmetic reasons. At minimum, I counsel on the increased risk of squamous cell carcinoma within the lesion and recommend sun protection. If treatment is desired, cryotherapy, topical retinoids, imiquimod, and topical 5-FU are all reported treatments. These are reasonable approaches in patients with single or few porokeratoses but their use could be limited in disseminated actinic porokeratoses due...

From time to time in my region, an isolated porokeratosis can become a problem, particularly on the legs of older female patients. Excision with grafting or other closure can be required if a trial of the above-noted creams fails. I have not had good results with any creams with larger lesions. The lesions only get bigger over the years, so here is a vote for timely removal, if appropriate.