Acquired perforating dermatosis in a patient with chronic renal failure

Reactive perforating dermatosis is a rare chronic skin disease defined by the transepidermal elimination of collagen and/or elastin. In the acquired form in adults, it is frequently associated with diseases such as diabetes and chronic renal failure. No systematic reviews of treatment options are available for this disease. The aim of this systematic review is to summarize all reported treatment options for acquired reactive perforating dermatosis (ARPD). This is a systematic review based on a MEDLINE search of articles in English and German from 1990 to 2016. Most medical literature on the treatment of ARPD is limited to individual case reports and small series of patients. Various therapies that have been tried include antihistamines, topical keratolytics, corticosteroids, tretinoin, oral drugs such as allopurinol or antibiotics, and phototherapy or photochemotherapy. While there are no specific criteria for the evidence-based selection of treatment options for ARPD, the first priority in management of these conditions should be treatment of an underlying disease if present. None of the described modalities has been approved for first-line therapy. It is recommended to choose a combination of drugs that reduce itching and assist in the resolution of the skin lesions at the same time.

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“…Treatment with allopurinol was reported in 12 case reports and case series . In all cases, improvement of skin lesions was described.…”

Section: Resultsmentioning

confidence: 99%

Treatment of acquired reactive perforating dermatosis – a systematic review

Lukács

Schliemann

Elsner

2018

J Deutsche Derma Gesell

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“…1,2 APD were reported to accompany systemic disorders in adult patients, mainly chronic renal failure and diabetes mellitus. 4,5 Proinflammatory mediators, diabetic microangiopathy with tissue hypoxia and chronic renal failure-related oxidative stress were therefore implicated in the persistence and progression of symptoms of APD despite attempted treatments. 2…”

Section: Discussionmentioning

confidence: 99%

Uncharted surgical therapy for acquired perforating dermatoses

Izzat

Kahila

Izzat

et al. 2022

Asian Cardiovasc Thorac Ann

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Acquired perforating dermatoses represent an uncommon group of chronic papulonodular dermatoses of unknown aetiology, characterized clinically by intense itching; and histopathologically by transepidermal elimination of dermal components. Definitive targeted pharmacological approaches are lacking, and the disease is usually refractory to therapy. We report here a case of rapid remission of acquired perforating dermatosis following simple thymectomy. If a role for the thymus in the pathogenesis of acquired perforating dermatoses was to be established, this could pave the way for a yet uncharted surgical therapy for these debilitating conditions.

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“…Narrow-band ultraviolet B therapy appears to be most effective in the setting of CKD. 9 Other reported medical treatments for APD include topical retinoids as well as oral or intralesional corticosteroids. For more severe cases, methotrexate or oral retinoids can be considered.…”

Section: Discussionmentioning

confidence: 99%