... the patient presented with multiple lesions. Porokeratoma usually appears in patients without a personal or familial history of porokeratosis. Although many cases of porokeratosis have been associated with immunosuppression, none of the cases of porokeratoma described to date has shown this association...

... without evidence of muscle weakness. Despite topical corticosteroids, the eruption progressed 9 months later to include generalized hyperkeratotic follicular papules, islands of sparing, and atrophic macules with a collarette of scale suggestive of porokeratosis. Mild dysphonia was the only sign of muscle...