Dermatologic disorders

Study Examines Role of Double-Ended Pseudocomedones in Hidradenitis Suppurativa

Double-ended pseudocomedones (DEP) are should be considered the outcome of chronic and relapsing course of hidradenitis suppurativa (HS), according to the results of a recent study.

DEP are commonly seen as a clinical sign of HS. In order to evaluate the clinical, dermoscopic, and histopathological features of DEP and to identify a clinicopathological correlation, researchers evaluated 37 patients with current or past HS.
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The researchers identified 64 DEP from 20 of the participants (14 with multiple DEP and 6 with a single DEP). The researchers assessed the DEP using dermoscopy at X10 using polarized and incident light. 

Dermoscopically, DEP appeared as coupled hollows surrounded by whitish cicatricial tissue. Keratin accumulation was observed within the hollows. Histopathologically, DEP corresponded to large hollows with dilated superficial openings.

“In our cases, we have noticed that all DEP resulted from the healing of previous inflammatory lesions, as confirmed by their constant presence within a cicatricial tissue. DEP may thus result from keratinization of the residual stump of 2 adjacent follicles undergoing cicatricial rearrangements,” the researchers wrote.

“Dermoscopy may enhance the diagnostic accuracy by revealing findings not appreciable at naked eye evaluation and may help to better understand some pathogenetic mechanisms underlying this ill-defined disorder.”

—Michael Potts

Reference:

Lacarrubba F, Micali G, Musumeci ML, et al. Double-ended pseudocomedones in hidradenitis suppurativa: clinical, dermoscopic, and histopathological correlation [presented at the American Academy of Dermatology 75th Annual Meeting]. Orlando, Florida. March 4, 2017.