Acquired perforating dermatosis
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| specialty = Dermatology
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Acquired perforating dermatosis is clinically and histopathologically similar to perforating folliculitis, also associated with chronic kidney failure, with or without hemodialysis or peritoneal dialysis, and/or diabetes mellitus, but not identical to Kyrle disease.Freedberg, et al. (2003). Fitzpatrick's Dermatology in General Medicine. (6th ed.). Page 540. McGraw-Hill. {{ISBN|0-07-138076-0}}.{{cite book |author =Rapini, Ronald P. |author2 =Bolognia, Jean L. |author3 =Jorizzo, Joseph L. |title=Dermatology: 2-Volume Set |publisher=Mosby |location=St. Louis |year=2007 |isbn=978-1-4160-2999-1 }}{{rp|1462}}
Signs and symptoms
On the hair-bearing limbs of adults, acquired perforating dermatosis typically manifests as extremely itchy follicular hyperkeratotic papules, which can occasionally become umbilicated. There may also be widespread papules.{{cite journal | last1=Lynde | first1=C. B. | last2=Pratt | first2=M. D. | title=Acquired perforating dermatosis: association with diabetes and renal failure | journal=Canadian Medical Association Journal | publisher=CMA Joule Inc. | volume=181 | issue=9 | date=August 17, 2009 | issn=0820-3946 | doi=10.1503/cmaj.082013 | pages=615| pmid=19687103 | pmc=2764758 }}
Causes
It is common for acquired perforating dermatosis to be linked to either renal failure, diabetes mellitus, or both. Ten percent or so of dialysis patients develop acquired perforating dermatosis.{{cite journal | last1=Morton | first1=C.A. | last2=Henderson | first2=I.S. | last3=Jones | first3=M.C. | last4=Lowe | first4=J.G. | title=Acquired perforating dermatosis in a British dialysis population | journal=British Journal of Dermatology | volume=135 | issue=5 | date=1996 | doi=10.1046/j.1365-2133.1996.d01-1062.x | pages=671–677| pmid=8977664 | s2cid=40685501 }} Additionally, it is sporadically linked to HIV, malignancy, hypothyroidism, and liver disease.{{cite journal | last1=Saray | first1=Y | last2=Seçkin | first2=D | last3=Bilezikçi | first3=B | title=Acquired perforating dermatosis: clinicopathological features in twenty-two cases | journal=Journal of the European Academy of Dermatology and Venereology | publisher=Wiley | volume=20 | issue=6 | date=May 5, 2006 | issn=0926-9959 | doi=10.1111/j.1468-3083.2006.01571.x | pages=679–688| pmid=16836495 | s2cid=19794920 }}
Diagnosis
The patient's medical history, the lesions' clinical appearance, and, most importantly, histopathology with the identification of typical histological characteristics are all important in the diagnosis of acquired perforating dermatosis.{{cite web | last1=Harbaoui | first1=Sarra | last2=Litaiem | first2=Noureddine | title=Acquired Perforating Dermatosis | publisher=StatPearls Publishing | date=February 13, 2023 | pmid=30969537 |url=https://www.ncbi.nlm.nih.gov/books/NBK539715/ | access-date=February 1, 2024}} Bright white clouds and structureless grey areas are visible on dermatoscopy during acquired perforating dermatosis, and these features may help differentiate the condition from prurigo nodularis.{{cite journal | last1=García-Malinis | first1=A.J. | last2=del Valle Sánchez | first2=E. | last3=Sánchez-Salas | first3=M.P. | last4=del Prado | first4=E. | last5=Coscojuela | first5=C. | last6=Gilaberte | first6=Y. | title=Acquired perforating dermatosis: clinicopathological study of 31 cases, emphasizing pathogenesis and treatment | journal=Journal of the European Academy of Dermatology and Venereology | publisher=Wiley | volume=31 | issue=10 | date=April 10, 2017 | issn=0926-9959 | doi=10.1111/jdv.14220 | pages=1757–1763| pmid=28300323 | s2cid=5319226 }}
Treatment
Since koebnerization can aggravate perforating disorders, treatment may focus on reducing pruritus. The majority of treatment approaches, such as topical or intralesional corticosteroids and oral or topical retinoids, are backed by anecdotal evidence. For pruritus, phototherapy (broad-band or narrow-band UVB, or psoralen plus UVA) may be beneficial. Other strategies include destructive techniques like cryotherapy, laser therapy, and surgical debridement, as well as the use of antibiotics like doxycycline.
See also
References
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Further reading
- {{cite journal | last1=Wang | first1=Wenju | last2=Liao | first2=Yansen | last3=Fu | first3=Lixin | last4=Kan | first4=Bei | last5=Peng | first5=Xiaodong | last6=Lu | first6=Yonghong | title=Dermoscopy Features of Acquired Perforating Dermatosis Among 39 Patients | journal=Frontiers in Medicine | volume=8 | date=2021-04-08 | issn=2296-858X | pmid=33898479 | pmc=8060433 | doi=10.3389/fmed.2021.631642 | doi-access=free | ref=none}}
- {{cite journal | last1=González-Lara | first1=L. | last2=Gómez-Bernal | first2=S. | last3=Vázquez-López | first3=F. | last4=Vivanco-Allende | first4=B. | title=Acquired Perforating Dermatosis: A Report of 8 Cases | journal=Actas Dermo-Sifiliográficas (English Edition) | publisher=Elsevier BV | volume=105 | issue=6 | year=2014 | issn=1578-2190 | doi=10.1016/j.adengl.2014.05.007 | pages=e39–e43 | ref=none| doi-access=free }}
External links
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{{Cutaneous keratosis, ulcer, atrophy, and necrobiosis}}