Demographic and Histologic Study of Patients with Perforating Dermatoses-Seven-Year Retrospective Study

Abstract

Background and Aim: Perforating dermatoses are uncommon skin disorders that are characterized by the extrusion of dermal elements through the epidermis. To evaluate the demographic, clinical, and histological features of patients with perforating dermatoses.
Materials and Methods: This is a seven-year retrospective study, from 2013 to 2019, at Razi Dermatology Hospital, including 100 patients with confirmed perforating dermatoses, aged between 15 and 85 years. Demographics, clinical presentation, associated comorbidities, and histopathological findings were recorded and analyzed using SPSS version 22. The significance level was considered p < 0.05.
Results: Our population consisted of 52% (52) females and 48% (48) males, with a mean age of 49.7 years. Diabetes (55%) and CKD (25%) were the most common comorbidities. Perforating folliculitis was diagnosed in 71 patients, while 29 had reactive perforating collagenosis. Histopathological analysis revealed key findings: perforating folliculitis cases displayed dilation of the follicular infundibulum, compact parakeratotic plugs, basophilic debris from inflammatory cells, and collagen bundles perforating the follicular epithelium, accompanied by perifollicular inflammatory infiltration. The characteristic findings in the cases of reactive perforating collagenosis included keratotic plugs within epidermal channels, degenerated collagen bundles in the widened papillary dermis, and neutrophilic scale crusts. Lesions predominantly involved the lower extremities (51%), followed by the trunk (14%), and scalp (8%). These Histopathological patterns were consistent across cases, affirming the diagnostic markers of each condition.
Conclusion: This study emphasizes that perforating dermatoses are strongly associated with systemic conditions such as diabetes (55%) and CKD (25%), thus demanding comprehensive management approaches. The histopathological consistency of the perforating dermatoses not only confirms diagnostic reliability and demographic variations but also suggests the need for further research on potential regional influences. These insights provide a foundation for improving therapeutic strategies and enhancing outcomes for patients with these challenging dermatologic conditions.