Atypical Presentation of Disseminated Porokeratosis with Extensive Cutaneous Horns

Porokeratosis (PK) remains an enigmatic skin disorder in terms of its etiopathogenesis, clinical manifestations, histopathological features, and therapeutic approaches. We report the case of a 65-year-old male presenting with a 35-year history of multiple oval annular plaques characterized by a central groove and prominent keratotic ridges along the periphery. Lesions were distributed over the bilateral upper limbs, lower limbs, and trunk. The chronic, slowly progressive nature of the plaques, along with their classic morphological features, raised a strong clinical suspicion of PK. A biopsy was performed to exclude malignancy, which was subsequently ruled out. This appears to be the first reported case of disseminated PK presenting with extensive cutaneous horns in the literature.