All pain, no gain: Porokeratosis ptychotropica remains a therapeutic challenge.

Porokeratosis ptychotropica (PPt) is a rare and therapeutically challenging variant of porokeratosis. Recent insights into dysregulated isoprenoid biosynthesis have suggested new therapeutic targets, though clinical success remains variable. We present two cases of PPt, one from London and one from Brighton, and their treatment outcomes, evaluating topical imiquimod and cholesterol/statin combination therapy. While imiquimod was poorly tolerated and ineffective, cholesterol/statin therapy provided symptomatic relief. These cases add to the limited literature on PPt and highlight the ongoing challenges in its management.