Acquired perforating dermatosis in renal and diabetic patients

Abstract

Advances in skin biology continue to reveal the importance and complexity of dermal-epidermal interrelation in healthy and diseased skin. The perforating dermatoses form an intriguing example of a disturbance in this relation. Although their histological hallmark, transepidermal elimination, can occur occasionally in several skin diseases, it predominates in the four conditions regarded as the primary perforating dermatoses: Kyrle's disease (originally described as a papular eruption characterised histologically by elimination of keratotic material), perforating folliculitis (where histologically the process occurs around a hair follicle), reactive perforating collagenosis (a rare condition, usually starting in childhood, in which collagen is eliminated through the epidermis), and elastosis perforans serpiginosa (where elastin is eliminated through the epidermis, again usually commencing in childhood).