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Axillary granular parakeratosis - Skin in Child
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Axillary granular parakeratosis - Skin in Child

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Contributors: Marie Crisel B. Erfe MD, Noah Craft MD, PhD, Jeffrey D. Bernhard MD, Belinda Tan MD, PhD, Sarah Stein MD, Karen Wiss MD, Sheila Galbraith MD, Craig N. Burkhart MD, Dean Morrell MD, Lynn Garfunkel MD, Nancy Esterly MD
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Synopsis

Axillary granular parakeratosis (AGP), also known as intertriginous granular parakeratosis, is a rare benign acquired disorder of keratinization thought to result from an error in epidermal differentiation. The more general term "granular parakeratosis" (GP) is used to describe the presentation in body areas other than the axillae, such as the groin, chest, or neck.

AGP typically presents as erythematous, violaceous, or brown papules that occasionally coalesce into plaques. Lesions can be pruritic and friable. AGP has a relatively chronic course and can persist for several months or resolve spontaneously, but recurrence is common.

The etiology is unknown, but various theories include irritant or allergic contact reactions directed against a component of a deodorant or antiperspirant, occlusion, excessive use of creams, excessive sweating, and obesity. A related theory is that AGP is a protective mechanism in humid body regions exposed to mechanical irritation.

GP can occur in individuals of all ages and both sexes. However, it is more common in women between 40 and 60 years of age, with a female-to-male ratio of 25:1. Reports of cases in children have been associated with diaper use, excessive washing, and use of topical zinc oxide. It occurs in all races and ethnicities.

Variants include follicular GP, which is confined to the follicle, and GP of the eccrine ostia, which has been associated with sweating or high temperatures. In anecdotal case reports, GP has been associated with dermatomyositis, molluscum contagiosum, and cancer.

Codes

ICD10CM:
R23.4 – Changes in skin texture

SNOMEDCT:
56585003 – Parakeratosis of skin

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Last Updated: 09/04/2013
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Axillary granular parakeratosis - Skin in Child
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Axillary granular parakeratosis : Axilla, Scaly plaques
Clinical image of Axillary granular parakeratosis
A brownish plaque with brown keratotic projections in the axilla.
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