A Rare Case of Porokeratosis Arising in Association with a Verruca

Porokeratosis is a rare keratinizing disorder of the epidermis that carries an increased risk of malignant transformation. Among its less common variants is verrucous porokeratosis, which can mimic benign skin conditions such as verruca vulgaris. We present the case of a 57-year-old male who developed a lesion on the posterior heel, initially treated as a verruca, which recurred and was later diagnosed via shave biopsy as porokeratosis arising in association with a verruca. A literature search of PubMed and Google Scholar did not identify any prior reports of porokeratosis arising in association with a verruca on the posterior heel. The lesion's location and the patient’s occupational exposure to repetitive friction suggest a contributory role of chronic mechanical trauma in its pathogenesis. This case highlights the diagnostic challenge of distinguishing porokeratosis from common verrucous lesions and underscores the importance of histologic evaluation in atypical or recurrent presentations. Given its premalignant potential, early recognition and dermatologic referral are essential to guide appropriate management.