Granular parakeratosis: A case report and literature review

Christopher A. Wallace, Rita O. Pichardo, Gil Yosipovitch, John Hancox, Omar P. Sangueza

Research output: Contribution to journalArticlepeer-review

43 Scopus citations


Background: Granular parakeratosis is suspected to result from an error in epidermal differentiation, leading to variably pruritic, hyperpigmented-to-erythematous patches and plaques. Characteristic histopathologic features include a thickened stratum corneum, compact parakeratosis with retention of keratohyalin granules, vascular proliferation, and ectasia. The pathogenesis of this entity is uncertain. Methods: We present a case of axillary granular parakeratosis and review the literature. Results: The lesion showed a thickened stratum corneum with compact parakeratosis, slight epidermal hyperplasia, and a sparse perivascular lymphohistiocytic infiltrate. Keratohyalin granules were diffusely present within the parakeratotic stratum corneum, and the retained granular layer showed focal vacuolization. Conclusions: Granular parakeratosis is a rare form of parakeratosis most often seen in the axilla, although other intertriginous areas may be affected. Unique histopathologic findings allow for a specific diagnosis to be made. Although an irritant contact reaction appears causative, mechanical irritation may also play a role in inducing these skin changes.

Original languageEnglish (US)
Pages (from-to)332-335
Number of pages4
JournalJournal of Cutaneous Pathology
Issue number5
StatePublished - May 2003
Externally publishedYes

ASJC Scopus subject areas

  • Pathology and Forensic Medicine
  • Histology
  • Dermatology


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