Pathology of Granular Parakeratosis

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Granular parakeratosis (originally termed axillary granular parakeratosis) is a rare form of parakeratosis.

It is an idiopathic, benign, nondisabling cutaneous disease located within the intertriginous areas.

Clinically two different patterns are recognized-lichen planus-like red-brown slightly hyperkeratotic or scaly papules, and larger plaques which are either bright red shiny or grey-brown with lichenification.

Granular parakeratosis microscopically demonstrates parakeratosis together with retention of keratohyalin granules within a thickened stratum corneum.

The granular layer is preserved and, in some areas, hypergranulosis is found.

It presents in all age groups and there is no established clinical associations

In women the lesions occurred in submammary region, axillae and popliteal fossa, in men, groin and genital region.

It remains unclear whether granular parakeratosis is a disease entity or whether it reflects a reaction pattern to unknown stimuli.

According to some authors granular parakeratosis is suspected to result from an error in epidermal differentiation.

The lesion is probably due to contact with some irritant substance (Example: antiperspirant or deodorant).

Mechanical irritation may also play a role in this condition.