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April 9, 1982

Renal Failure and Perforating Folliculitis

Author Affiliations

University of Texas Medical Branch Galveston

JAMA. 1982;247(14):1936. doi:10.1001/jama.1982.03320390020013

To the Editor.—  Perforating folliculitis was first described by Mehregan and Coskey1 in 1968. It belongs to the group of diseases exhibiting transepidermal elimination that includes Kyrle's disease, elastosis perforans serpiginosa, reactive perforating collagenosis, and calcinosis cutis. In contrast to Kyrle's disease, which has been associated with diabetes mellitus, hepatic insufficiency, and congestive heart failure,2,3 there has been no consistent disease association reported with perforating folliculitis.In the past three years, we have seen four cases of perforating folliculitis in the dermatology department at the University of Texas Medical Branch at Galveston. All of these cases occurred in patients with chronic renal failure. There were two women and two men, all of whom were middle-aged. Two of the patients had a history of juvenile-onset diabetes mellitus, while the other two patients had a history of adult-onset diabetes mellitus. In all cases, diabetic nephropathy was believed to be the