Follicular keratotic diseases: a retrospective study of 50 cases in a tertiary care center of rural South India with dermoscopy and histopathology evaluation

Kaushik T. Thomas; Hari Kishan Kumar Yadalla; Naveen Shivappa

doi:10.18203/issn.2455-4529.IntJResDermatol20254118

Authors

Kaushik T. Thomas Department of Dermatology, Rajarajeswari Medical College and Hospital, Kengeri, Bangalore, Karnataka, India
Hari Kishan Kumar Yadalla Department of Dermatology, Rajarajeswari Medical College and Hospital, Kengeri, Bangalore, Karnataka, India
Naveen Shivappa Rajarajeswari Medical College and Hospital, Kengeri, Bangalore, Karnataka, India

DOI:

https://doi.org/10.18203/issn.2455-4529.IntJResDermatol20254118

Keywords:

Follicular keratotic diseases, Keratosis pilaris, Dermoscopy, Histopathology, Phrynoderma, Lichen spinulosis, Follicular lichen planus, Follicular psoriasis

Abstract

Background: Follicular keratotic diseases involve abnormal keratinization in hair follicles, causing follicular papules, hyperkeratosis, and perifollicular erythema. These disorders include diseases like phrynoderma, keratosis pilaris, lichen spinulosis psoriasis, eczema, and lichen planus. Dermoscopy is a non-invasive tool which can be used to differentiate diseases without the need of invasive procedures.

Methods: This study is a hospital based cross sectional study of 50 patients diagnosed with follicular keratotic diseases irrespective of age, sex, and duration of disease. Histopathological and dermoscopic findings of these disorders were noted.

Results: Keratosis pilaris was the most common follicular keratotic disease (FKD), predominantly affecting adolescent and young adult females. Lesions appeared mainly on the arms (92%), legss (48.3%), and lateral part of thigh (31.3%). Other follicular keratotic diseases observed were follicular eczema (10%), phrynoderma (10%), pityriasis rubra pilaris (10%) follicular lichen planus (2%), follicular psoriasis (2%), and lichen spinulosus (2%). Dermoscopy showed perifollicular scaling, erythema, keratin plugs, and white halos, while histopathology confirmed hyperkeratosis, follicular dilation, and minimal inflammation.

Conclusion: The study highlights keratosis pilaris as the most common FKD, with dermoscopic and histopathological correlations playing a crucial role in accurate diagnosis. As all the FKD and clinically similar confirmation of diagnosis depends on dermoscopy and histopathology. The findings also emphasize the importance of non-invasive techniques like dermoscopy in distinguishing KP from other follicular disorders and guiding effective management strategies.

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