From the Guidelines
Perforating dermatosis, also known as Acquired Perforating Dermatosis, should be treated with topical retinoids, corticosteroids, and keratolytics like salicylic acid or urea creams, with consideration of oral medications such as allopurinol, isotretinoin, or tetracyclines for more severe cases, and narrowband UVB phototherapy for widespread lesions, as there is no specific evidence-based treatment recommended in the provided studies 1.
Diagnosis and Treatment
The diagnosis of perforating dermatosis involves identifying the characteristic small, dome-shaped papules with a central keratotic plug, often causing intense itching, and associating them with systemic diseases like diabetes mellitus and chronic kidney disease requiring dialysis.
- The main types of perforating dermatosis include reactive perforating collagenosis, elastosis perforans serpiginosa, perforating folliculitis, and Kyrle disease.
- Treatment focuses on addressing the underlying condition when possible, along with symptomatic management.
- Topical treatments include: + Retinoids + Corticosteroids + Keratolytics like salicylic acid or urea creams
- For more severe cases, oral medications such as: + Allopurinol (100-300 mg daily) + Isotretinoin (0.5-1 mg/kg/day) + Tetracyclines (doxycycline 100 mg twice daily) may be prescribed.
Pathophysiology and Supportive Measures
The pathophysiology of perforating dermatosis involves abnormal collagen or elastic fibers that become damaged and are subsequently eliminated through the epidermis, often triggered by minor trauma like scratching in predisposed individuals.
- Maintaining good skin hydration and avoiding scratching are important supportive measures.
- Narrowband UVB phototherapy can also be effective for widespread lesions, as seen in other skin conditions treated with TL-01 1.