Perforating folliculitis is 1 of 4 classic perforating dermatoses that are now grouped under the umbrella term of "acquired perforating dermatoses," along with elastosis perforans serpiginosa, reactive perforating collagenosis, and Kyrle disease. Acquired perforating dermatoses are often associated with diabetes mellitus or chronic renal disease; however, they may also occur in patients with other systemic diseases, in association with medications such as tumor necrosis factor (TNF)-alpha inhibitors, and in patients without an underlying disease. Perforating folliculitis specifically has also been described in the setting of psoriasis, cardiovascular disease, hypertension, primary sclerosing cholangitis, HIV infection, and trauma.

Perforating folliculitis is so named for the process in which dermal material is eliminated transepidermally (transfollicularly). Clinically, there are scaly papules in hair-bearing areas that may be asymptomatic to severely pruritic. Perforating folliculitis is reported to occur more frequently in women and is most prevalent in adulthood.

Without treatment, perforating folliculitis tends to persist for long periods of time. It often regresses with stabilization of renal disease or renal transplant.