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November 1983

Keratotic Papules of Chronic Renal Failure: The Process of Transepithelial Elimination

Author Affiliations

Division of Dermatology Scott and White Clinic 2401 S 31st St Temple, TX 76508

Arch Dermatol. 1983;119(11):874-875. doi:10.1001/archderm.1983.01650350002003

To the Editor.—  For many years, dermatologists have been observing patients with chronic renal failure treated with renal dialysis in whom an unusual hyperkeratotic papular eruption develops. A single case of this type with chronic renal failure in predialysis days was reported in 1961, and was labeled "hyperkeratosis penetrans" (Kyrle's disease), which it resembled both clinically and histologically.1 During the past two years, 34 additional cases have been reported under the name of Kyrle's disease (14 cases), perforating folliculitis (14 cases), and reactive perforating collagenosis (6 cases). I would like to report a case involving a patient with chronic renal failure being treated with hemodialysis in whom elastic fibers appeared to be perforating the epidermis, suggesting a diagnosis of elastosis perforans serpiginosa.

Report of a Case.—  A 51-year-old white man was examined at the Scott and White Clinic in Temple, Texas for a generalized, disseminated skin eruption. The patient

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