Acquired perforating dermatosis: clinicopathological features in twenty-two cases

Area of Science:

• Dermatology
• Pathology
• Nephrology

Background:

• Acquired perforating dermatosis (APD) encompasses perforating skin disorders in adults.
• APD exhibits variable clinical and histological features, mimicking classic perforating conditions like elastosis perforans serpiginosa, reactive perforating collagenosis, perforating folliculitis, and Kyrle's disease.
• Chronic renal failure and diabetes mellitus are common comorbidities.

Purpose of the Study:

• To characterize the clinical and histopathological aspects of APD.
• To explore the relationship between APD and associated systemic diseases.

Main Methods:

• Study included 22 patients diagnosed with APD.
• Clinical data and associated conditions were documented.
• Histopathological evaluation involved H&E staining, with special stains including elastic van Gieson, Masson trichrome, and PAS.

Main Results:

• Observed clinical and histopathological features aligned with the four classic perforating dermatoses.
• A high prevalence of systemic diseases was noted, with chronic renal failure (72.7%) and diabetes mellitus (50%) being most common.
• Most patients with diabetes had concurrent chronic renal failure; all with renal failure were on dialysis. Other conditions included hepatitis, hypothyroidism, and tuberculosis.

Conclusions:

• APD represents a spectrum of perforating disorders, not merely variants of a single disease.
• While frequently associated with diabetes and chronic renal failure, APD can occur independently or with other systemic conditions.
• Dialysis treatment may play a role in the development of APD in patients with chronic renal failure.