Kyrle's disease associated with HIV infection, diabetes, and chronic kidney disease

Farias, Geysa Maria Nogueira; Pinto, José; Melo, Juliana Carneiro; Távora, Lara Gurgel Fernandes; Lima, Danielle Malta; Correia, Fernanda Judith Viana; Júnior, Geraldo Bezerra da Silva

doi:10.4103/ijpm.ijpm_532_17

Cited by 5 publications

References 7 publications

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HIV and the Skin

Bunker,

Piguet

2024

Rook's Textbook of Dermatology

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Within 2 years of defining acquired immune deficiency syndrome (AIDS) as a distinctive syndrome in 1981, human immunodeficiency virus (HIV) was identified as the causative agent. Dermatological involvement in AIDS has been appreciated since the disease was first recognised. Mucocutaneous involvement establishes criteria for diagnosis and staging; the prognostic significance of some complications, for example pruritic papular eruption/eosinophilic folliculitis, hairy leukoplakia and Kaposi sarcoma (KS), was well recognised before specific treatments were introduced. The proportion of patients with skin complications and the number of these manifestations in any one patient increase as HIV infection progresses and AIDS develops. The incidence and severity of several common cutaneous diseases (such as mollusca, herpes simplex and seborrhoeic dermatitis) are increased in patients with HIV and this correlates in many instances with the absolute numbers of CD4+ T cells. The effect HIV infection may have on some dermatological conditions such as psoriasis and leprosy is less clear‐cut. The advent of highly active combined antiretroviral therapy (ART) has been incalculably beneficial to patients with HIV, but novel side effects of these drugs (such as lipodystrophy) have emerged, and the skin can be affected by manifestations of the immune reconstitution inflammatory syndrome/immune reconstitution associated disease. The dermatological complications of HIV and AIDS may be distressing to patients and difficult for dermatologists to diagnose and manage. Also, many dermatoses presenting in the population at large need to be regarded as ‘indicator conditions’ to prompt advice about, and initiation of, HIV testing.

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HIV and the Skin

Bunker,

Piguet

2024

Rook's Textbook of Dermatology

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Clinical practice guide for the treatment of perforating dermatosis

Kawakami

Akiyama

Ishida‐Yamamoto

et al. 2020

The Journal of Dermatology

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Perforating dermatoses are a heterogeneous skin disease group defined by transepidermal elimination of various skin materials. Four classical forms of primary perforating dermatosis have been described, where the transepidermal elimination mechanism represents the hallmark of the disease: acquired reactive perforating collagenosis, elastosis perforans serpiginosa, Kyrle's disease and perforating folliculitis. Acquired reactive perforating collagenosis presents with transepidermal elimination of collagen fibers. Elastosis perforans serpiginosum presents with the elimination of elastic fibers. Kyrle's disease presents with transepidermal elimination of abnormal keratin. In perforating folliculitis, it is the content of the follicle. We established diagnostic criteria and severity classification. In addition, the Japanese guideline for treatment of perforating dermatoses was updated using the Medical Information Network Distribution Service (MINDS) methodology. The guideline is based on a systematic published work review completed from 1989 to 2019, and on a formal consensus and approval process. Most medical published work on the treatment is limited to individual case reports and small series of patients. The guideline covers treatment options considered relevant by the expert panel and approved in Japan at the time of the consensus conference.

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Acquired perforating dermatosis: clinicopathologic study of a 10‐year period at a tertiary teaching hospital

et al. 2019

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Background Acquired perforating dermatosis (APD) comprises an uncommon group of skin disorders that develop in adulthood in association with systemic diseases. The aim of this study was to characterize clinicopathologic features and treatment outcomes in a series of patients diagnosed with APD. Methods Retrospective study of all patients diagnosed with an APD over a 10‐year period (2009–2018) at a tertiary teaching hospital in Lisbon, Portugal. Results Fifty‐seven patients with APD were identified. Thirty‐five patients presented lesions in multiple anatomic areas (61.4%), and the lower limbs were the most common location. Forty‐six patients reported pruritus (80.7%), which was classified as severe in 21 of them (36.8%). An underlying systemic disease was identified in 53 patients (93.0%). Diabetes mellitus (DM) and chronic kidney disease (CKD) were the most common associated systemic diseases, but psychiatric disorders, malignancies, and chronic infections were present in a significant number of patients. The combination of topical steroids with antihistamines was the most prescribed initial treatment, but only 37.8% of the patients had a complete response. Acitretin, systemic steroids, and phototherapy were the treatments associated with the best outcome. Conclusion Acquired perforating dermatosis can be associated with many systemic disorders that have pruritus as a common factor. Chronic viral infections and an occult malignancy should be sought, particularly in the absence of DM and CKD. The management of APD is challenging and is best achieved with the control of the underlying systemic diseases.

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Kyrle's disease associated with HIV infection, diabetes, and chronic kidney disease

Cited by 5 publications

References 7 publications

HIV and the Skin

HIV and the Skin

Clinical practice guide for the treatment of perforating dermatosis

Acquired perforating dermatosis: clinicopathologic study of a 10‐year period at a tertiary teaching hospital

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