Porokeratosis is a rare disorder characterized by atrophic macules or patches, with a well-defined ridge-like hyperkeratotic border called cornoid lamella. Although the exact pathogenesis is unknown, drug associated cases have recently been reported in the literature. As such, we systematically reviewed and identified drugs associated with drug-induced
porokeratosis, their resultant effects, and whether there was a casual relationship between the use of a drug and the development of
porokeratosis. We searched for articles which reported drug-induced
porokeratosis in MEDLINE and Embase in June 2020. After full-text review, 25 studies were included for analysis. We identified 26 patients with drug-induced
porokeratosis. The most common
therapies associated with development of
porokeratosis is biologic use,
phototherapy, and
radiotherapy. The most common clinical variants were the disseminated superficial or actinic types (60%), which occurred in
psoriasis patients undergoing
phototherapy, and eruptive disseminated type (24%) which occurred in the context of
biologic therapies. The Naranjo score ranged from possible to probable for the identified treatments. Clinicians should consider drug reactions as possible triggering events for
porokeratosis, especially for patients taking biologics,
phototherapy, and
radiotherapy. Large-scale studies are required to confirm our findings and further explore the pathogenesis for drug-induced
porokeratosis.