For quite a few years, dermatologists have been fascinated with disorders of transepithelial elimination (TEE), sometimes termed the perforating dermatoses (perforating, as used here, does not necessarily imply penetration of the epidermis by products of keratinization or extrinsic substances). This fascination has been expressed in our literature principally in three forms: documentation of a wide variety of disorders in which TEE can be demonstrated; debate about the nosology of the primary perforating disorders, ie, Kyrle's disease, perforating folliculitis, reactive perforating collagenosis (RPC), and, to a lesser extent, elastosis perforans serpiginosa (EPS); and dissection of the possible mechanisms of TEE through investigative techniques.
Detlefs and Goette1 have stated that "in recent years, the dermatologic literature has been inundated with reports of incidental TEE in a wide variety of cutaneous lesions,"1 and certainly a review of our specialty journals bears this out. If one adheres to