Published: 2019-10-21

A retrospective clinicopathological study of cases of perforating dermatoses in a tertiary care centre

Saradha Kandasamy, Prathiba Subramanian, Geetharani Gopalan, Ashwini Krishnamoorthy


Background: Perforating deramtoses is a group of diseases characterized by extrusion of dermal materials such as inflammatory cells or extracellular substances through the epidermis. They can be classified as primary and secondary perforating dermatoses. This study was done to assess the prevalence and associated systemic diseases of perforating dermatoses in our setting.

Methods: This is a retrospective study done by reviewing the hospital records of patients who attended the skin OPD, Government Rajaji Hospital, Madurai Medical College, Madurai during the period June 2008 to June 2010. All patients diagnosed clinically as perforating dermatoses and supported by histopathological examination were included.

Results: Kyrle’s disease (54%) was the commonest type, followed by reactive perforating collagenosis (43%) and perforating calcific elastosis (3%). About 53% of the patients presented as hyperkeratotic papules and 43% as hyperkeratotic, plugged, umbilicated papules and plaques. Erythematous papules arranged in annular and serpiginous pattern in the periphery of the central atrophic plaques were noted in 1 patient (3%). Lower extremities (73%) were the most commonly involved site. (67%) patients had at least one systemic disease and commonest association was diabetes mellitus (53%), chronic renal failure (36%), hypothyroidism (3%).

Conclusions: Perforating dermatoses is a uncommon dermatological condition characterized by Trans Epidermal Elimination of dermal substances. Since it has a strong association with systemic diseases screening for systemic diseases is required for all cases.


Transepidermal elimination, Primary, Secondary, Extremities, Systemic associations

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