A Study of Clinical, Dermoscopic and Histopathological Correlation in Follicular Keratotic Diseases

Abstract

ackground: “Follicular keratotic disorder is an abnormal keratinization affecting the follicular orifices and clinically characterized by hyperkeratotic follicular papules affecting various sites”. Dermoscopy is a non-invasive diagnostic tool and differentiates closely resembling diseases as well as possibly prevents need for an invasive biopsy. Objective: This study was aimed to find the correlation between clinical, dermoscopic and histopathological findings in follicular keratotic diseases and to establish the dermoscopic criteria in the diagnosis of follicular keratotic diseases. Methods: This was a hospital based prospective cross-sectional study of patients clinically diagnosed with follicular keratotic diseases, irrespective of age, between 2018 and 2020. Results: The study consisted of 76 patients with a mean age of 26.7±2.4 years. The most common follicular keratotic disease observed was phrynoderma 22(28.9%) followed by keratosis pilaris 21(27.6%). The predominant dermoscopic finding was perifollicular scaling 73(96%) and keratotic plug 65 (85%). The most common histopathological feature was epidermal hyperkeratosis, dilated follicular infundibulum, follicular plug and dermal lymphocytic infiltration. The clinical and dermoscopic features showed a significant statistical association with the histopathological findings (P<0.006). Conclusion: Dermoscopy is a simple, non-invasive diagnostic tool that helps in differentiating and diagnosing the closely resembling follicular keratotic diseases.