Disseminated superficial actinic porokeratosis treated with tretinoin and calcipotriene

Disseminated superficial actinic porokeratosis (DSAP) is a chronic, benign condition characterized by red-brown colored macules to minimally elevated papules with classic peripheral, circumferential scale of cornoid lamellae photodistributed about the upper and lower extremities. Its often recalcitrant nature to treatment may be frustrating to both patient and provider. Commonly, first- and second-line treatments with cryotherapy, 5-fluorouracil 5% cream, imiquimod, retinoids, vitamin D3 analogs, topical diclofenac, or photodynamic therapy alone may be unsuccessful.