Acquired perforating follicuiitis in chronic renal failure: report of two cases

Background Patients wilh chronic renal failure, regardless of its cause, with/without hemodialysis/peritoncal dialysis, showed cutaneous alterations. Two patients had a follicular hyperkeratotic papular eruption, with clinical and histological features of perforating follicuiitis. Method.s A dermatological examination and multiple skin biopsies were done. Results We diagnosed acquired perforating follicuiitis in two chronic renal failure patients on hcmodialysis. The lesions were located predominantly on the lower extremities wilh hyperkeratotic papules and small nodules. Microscopically, the papule always affected ihc follicular structure. The follicle was widely dilated and packed with keratotic material, necrotic debris and degenerated basophilic coarse connective fibers passing which passed through foilicular perforations. Conclusion Acquired perforating follicuiitis is a cutaneous manifestation in chronic renal failure. with/without hemodialysis ireatment. that can mimic essential primary perforating follicuiitis. Transepidemial elimination mechanisms and the distinction between primary and acquired perforating dermatoses arc discussed.