Perforating disorders in patients with chronic renal failure (CRF), diabetes mellitus (DM), or both, may resemble any or all of the four classic cutaneous perforating disorders. However, due to the highly variable and overlapping histologic appearance of the lesions in patients with CRF, DM, or both, it may be useful to categorized these lesions as a distinct, yet encompassing process, termed b...

A 59-year-old man with chronic renal failure and diabetes mellitus presented with pruritic crusted lesions which histologically were perforating disorders, showing features of both Kyrle disease and acquired perforating collagenosis. The mechanisms of transepidermal elimination and the classification of perforating disorders are briefly discussed. Additionally, we question the concept of perfor...

ransepidermal elimination is a disorder in which T dermal stimuli profoundly effect the behavior and structure of the overlying epidermis. Briefly, there are two categories of disorders: the first are primary dermatoses and consist of elastosis perforans serpiginosa and reactive perforating collagenosis; the second group originates from alterations of dermal constituents in preexisting disorder...

APD: acquired perforating dermatosis CRF: chronic renal failure DM: diabetes mellitus EPS: elastosis perforans serpiginosa ESRD: end-stage renal disease RPC: reactive perforating collagenosis INTRODUCTION Perforating dermatosis is a heterogeneous group of disorders characterized by transepidermal elimination of dermal components such as collagen, elastin, or fibrin. Acquired perforating dermato...

Perforating dermatoses (PD) represent a rare group of papulonodular skin diseases with a distinct central keratotic core. The core represents the transepidermal elimination of an altered dermal substance.1 Diagnosis is established via biopsy and histopathologic evaluation. Whereas primary PD are diseases chiefly characterized by transepidermal elimination, secondary PD are a group of unrelated ...

Sir, Cutaneous manifestations are frequently found in patients with chronic renal failure. They can be classified as specific disorders (e.g. perforating disorders, metastatic calcification, bullous dermatosis) or non-specific disorders (e.g. skin colour changes, pruritus, elastosis, equimosis, xerosis, uraemic frost, half and half nails). We report here an unusual association between an acanth...

Transepidermal elimination (TE) is a mechanism whereby foreign or altered constituents can be removed from the dermis. This process involves unique morphologic alterations of the epidermis, which forms a channel and thereby facilitates extrusion of the desired dermal components. The phenomenon of TE may occur as a primary process characterizing disorders, such as elastosis perforans serpiginosa...

Reactive perforating collagenosis is one of the perforatingdermatoses; the acquired form is characterized by transepithelialelimination of altered collagen bundles. It has been seen inassociation with multiple disorders including diabetes mellitus,renal failure, hyperparathyroidism, liver disease, neurodermatitis,IgA nephropathy, and periampullary carcinoma with jaundice.According to the litera...