Dermatoses In Patients Research Articles

Two Unusual Cases of Discoid Lupus Erythematosus Associated With Xanthomatized Macrophages

We present 2 patients with chronic discoid lupus erythematosus (LE) associated with xanthomatized macrophages on light microscopic findings. Skin biopsies revealed hyperkeratotic and atrophic epidermis, vacuolar degeneration of the dermal-epidermal junction, thickened basement membrane, follicular plugging, and perivascular and perifollicular lymphohistiocytic infiltrate. Notably, large collections of lipid-laden histiocytes were observed within the subjacent dermis. The patients denied history of intralesional steroid treatment. The patients did not demonstrate any clinical or laboratory signs of hyperlipidemia, cholestasis, and diabetes mellitus and insipidus. Accumulation of lipid-laden foam cells in cutaneous LE is a rare phenomenon that has been reported in discoid LE and lupus panniculitis, each only once in the literature. It has also been described within lesions of various other dermatoses in patients without lipid, hepatic, or endocrine abnormalities. Its mechanism remains unclear, but it has been hypothesized that intracellular lipids released from degenerating cells contribute to lipidization of mononuclear scavengers. Xanthomatous infiltration in cutaneous LE is an unusual feature, and its presence may not necessarily signify an underlying metabolic disorder.

Dermatoses in parkinsonism: the importance of multidisciplinary follow-up.

Parkinsonism is characterized by bradykinesia with rigidity and/or resting tremor, in addition to non-motor symptoms, which include dermatological manifestations. The objective of this study is to evaluate the main dermatoses in patients with parkinsonism found at the Philanthropic Association of Curitiba - PR. A cross-sectional descriptive study was carried out with the application of a questionnaire and dermatological evaluation of the patients. The sample consisted of 386 patients and was composed mainly by men (55.4%), between 60-74 years old (51.6%), with complete primary education (45.3%), disease diagnosis time between 5-10 years (35%) and in use of medication (96.6%). The most prevalent dermatoses were pigmented nevus (36.3%), warts (25.1%), actinic keratosis (22%), seborrheic keratosis (21.5%), seborrheic dermatitis (20.5%), and rosacea (19.2%). Among the 13 cases (3.4%) of malignant cutaneous neoplasms confirmed by biopsy, 2 were melanomas. Regarding patients' sex, there was a higher prevalence of inflammatory dermatoses (OR 1.64, 95% CI 1.08-2.51, p = 0.025) and benign cutaneous neoplasms (OR 1.77, 95% CI 1.16-2.69, p = 0.01) in men. As to age, patients aged between 60-74 years had more pre-malignant skin lesions (OR 2.60, 95% CI 1.05-6.44, p <0.001) and seborrheic keratosis (OR 2.52, 95% CI 1.02-6.25, p = 0.001) and, in those older than 75 years, actinic keratosis was more frequent (OR 5.43, 95% CI 2.17-13.6, p <0.001). The results of the study show that it is fundamental to dermatologically evaluate and monitor these patients, aiming at diagnosis and early treatment of lesions, especially of skin cancer.

Assessment of the Development of New Regional Dermatoses in Patients Treated for Atopic Dermatitis With Dupilumab

This cohort study describes the epidemiology, clinical features, and treatment of patients with moderate-to-severe atopic dermatitis and the association of developing new regional dermatoses with dupilumab treatment.

Prevalence of non-infectious dermatoses in patients attending a tertiary care center in Rajasthan

&lt;p class="abstract"&gt;&lt;strong&gt;Background:&lt;/strong&gt; Pediatric dermatoses require a separate view from adult dermatoses as there are important differences in clinical presentation, treatment and prognosis. There is very little epidemiological study available on non-infectious childhood dermatoses in India. The aims of the study were to find the prevalence, clinical profile and various etiological factors associated with childhood non-infectious dermatoses and to determine the prevalence of most common non-infectious childhood dermatoses.&lt;/p&gt;&lt;p class="abstract"&gt;&lt;strong&gt;Methods:&lt;/strong&gt; This cross-sectional observational study conducted at tertiary care centre in Rajasthan, India. Children with age 13 years and below with clinical evidence of cutaneous disorders were studied. Parents who have not given consent for the study, acutely ill children, Children having infectious dermatoses (bacterial, fungal, viral, arthropods, parasitic and protozoal infection) were excluded from the study.&lt;strong&gt;&lt;/strong&gt;&lt;/p&gt;&lt;p class="abstract"&gt;&lt;strong&gt;Results:&lt;/strong&gt; A total of 232 cases were studied which showed a female preponderance of 55.60%. Most of the skin diseases were seen in the 5 to 13 years (school children) age group. The most common dermatoses was eczematous (36.63%), among eczema atopic diathesis was the commonest (17;20%) followed by hypersensitivity dermatoses (21.12%), genetic disorders (13.36%), disorders of genetic disorders (7.4%), sweat gland disorders (8.18%), pigmentary disorders (4.31%), papulo squamous disorders (4.74%), Nevi (6.46%).&lt;/p&gt;&lt;p class="abstract"&gt;&lt;strong&gt;Conclusions:&lt;/strong&gt; Eczematous dermatoses were the most commonly noted in the study, followed by hypersensitivity dermatoses. Atopic diathesis was the commonest endogenous eczemas. Acne, insect bite reaction and miliaria were the other common dermatoses. There was no significant association of various dermatoses with systemic diseases in the study.&lt;/p&gt;

Clinical profile of palmoplantar dermatoses in patients attending tertiary health center in central India

&lt;p class="abstract"&gt;&lt;strong&gt;Background:&lt;/strong&gt; Palmoplantar dermatoses include specific skin diseases affecting palm and soles and are frequently encountered dermatoses in the dermatology practice. Apart from diagnostic difficulties, few palmoplanter dermatoses cause great discomfort and disability and may also affect a person's livelihood.&lt;/p&gt;&lt;p class="abstract"&gt;&lt;strong&gt;Methods:&lt;/strong&gt; It was a cross sectional descriptive study conducted in the Department of Dermatology, Chirayu Medical College and Hospital, Bhopal. A total of 200 patients of palmoplanter dermatoses, attending outpatient department of dermatology of tertiary health center were enrolled for study.&lt;strong&gt;&lt;/strong&gt;&lt;/p&gt;&lt;p class="abstract"&gt;&lt;strong&gt;Results:&lt;/strong&gt; In our study, a total of 200 patients were included in the study, of which 116 (58.0%) were males and 84 (42.0%) were females. Male to female ratio was 1.38 showing male preponderance of disease. The most common age group affected was 31–40 years followed by 21–30 years in both the sexes. In our study, only palms were involved in 30 (15%) cases, soles in 39 (19.5%), and both palms and soles in 131 (65.5%) cases. Out of all palmoplanter dermatoses, 161 (80.5%) cases had palms and 170 (85%) cases had soles involvement. Palmoplantar psoriasis was the most common dermatoses found in 48 (24.0%) cases followed by palmoplanter keratoderma in 26 (13.0%).&lt;/p&gt;&lt;p class="abstract"&gt;&lt;strong&gt;Conclusions:&lt;/strong&gt; Early recognition of clinical symptoms and signs is important to plan further supportive diagnostic investigations as well as appropriate and effective management to further improve outcome of illness and the quality of life.&lt;/p&gt;

A study on spectrum of periorbital dermatoses in a tertiary centre

&lt;p class="abstract"&gt;&lt;strong&gt;Background:&lt;/strong&gt; To study the spectrum of periorbital dermatoses in patients of both genders irrespective of age and identify any underlying etiology.&lt;/p&gt;&lt;p class="abstract"&gt;&lt;strong&gt;Methods:&lt;/strong&gt; A clinico-epidemiological study of periorbital dermatoses was done in all patients with skin lesions in and around the both eyes who visited our outpatient department. Digital photographs will be taken for all the patients with periorbital dermatosis. Data obtained was compiled, tabulated, and statistically summarized using SPSS version 16.&lt;strong&gt;&lt;/strong&gt;&lt;/p&gt;&lt;p class="abstract"&gt;&lt;strong&gt;Results:&lt;/strong&gt; Among 110 patients, majority of patients with periorbital dermatoses, were in the age group of &amp;gt;50 years (40%) including 77 (70%) females and 33 (30%) males. The most common dermatoses observed in periorbital region were benign and malignant skin tumors 46 (41.8%), followed by pigmentary disorders 21 (19.1%), miscellaneous 19 (17.3%), nevoid conditions 12 (10.9%), eczema 6 (5.5%), and infections 6 (5.5%).&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusions:&lt;/strong&gt; Benign skin tumors and pigmentary disorders are the most common periorbital dermatoses seen in our study. Certain periorbital dermatoses like skin tag and xanthelesma are seen associated with underlying metabolic disorders. &lt;/p&gt;

Prevalence of dermatoses in patients referred for evaluation in an outpatient clinic of specialties

Background:Brazilian Unified Health System presents a long waiting period for a dermatology appointment, varying from 34 to 239 days. Objectives: Analyze the prevalence of cutaneous diseases evaluated by dermatologists in a specialized center, in patients referred from the primary care, and to present possible interventions for the primary units. Methods:Retrospective analyses of the International Codes of Diseases (ICD-10) described in every dermatology appointment in a specialty center in Sao Paulo from January 2014 to August 2015. Results:A total of 7.350 consultations were included. Superficial mycosis corresponded to 1,058 (14.4%) of the main complaints and dermatophytosis was the most frequently used ICD, corresponding to 481 individual consultations (6.5%), followed by onychomycosis, responsible for 464 consultations (6.3%), acne in 347 (4,7%). and contact dermatitis in 311 consultations (4,2%). Study limitations:The study was based on retrospective analysis of ICD described and no previous orientation for a solid use of the codes was performed to the dermatology team; consultations in which the ICD was not informed or a non-especific ICD was used were excluded; different dermatologists were responsible for the consultations. Conclusion:Superficial mycosis corresponded to 14.4% of the chief complaints in the studied period and was the most frequent cause of reference from primary care doctors to dermatologists. Prevalence data obtained in the present study could assist the capacitation policies in the primary care system, focusing the dermatology teaching in the most prevalent dermatological disorders.

Skin Manifestations in Patients with Adult-onset Immunodeficiency due to Anti-interferon-gamma Autoantibody: A Relationship with Systemic Infections.

Adult-onset immunodeficiency due to anti-interferon-γ autoantibody is an emerging acquired immunodeficiency with frequent skin manifestations. A retrospective chart review was conducted and identified 41 patients with the syndrome. Skin involvement was detected in 33 (80%) patients, 15 (45%) with infective skin diseases and 27 (82%) with reactive skin disorders. Reactive lesions were mostly neutrophilic dermatoses, e.g. Sweet syndrome. Of note, the presence of neutrophilic dermatoses was highly associated with infections of other sites. An adjusted odds ratio for the existence of infections in patients with neutrophilic dermatoses was 14.79 (95% CI: 5.13, 42.70; p < 0.001). Moreover, neutrophilic dermatoses were significantly correlated with opportunistic infections observed in those with defects in cell-mediated immunity including non-tuberculous mycobacterium and disseminated fungal infection. The odds ratio for opportunistic infections in the presence of neutrophilic dermatoses was 12.35 (95% CI: 5.00, 30.55; p <0.001). Thus, the presence of neutrophilic dermatoses in patients with the syndrome can signal opportunistic infections that warrant physician attention.

A retrospective study on the incidence of non-venereal genital dermatoses in patients attending STI clinic at a tertiary care centre

&lt;p class="abstract"&gt;&lt;strong&gt;Background:&lt;/strong&gt; To study the clinical and epidemiological pattern of occurrence of non-venereal genital dermatoses among the patients attending STI clinic. Also an attempt was made to know the level of awareness among the patients studied and the level of psychological impact on the affected persons before they were diagnosed as anon venerealdermatoses.&lt;/p&gt;&lt;p class="abstract"&gt;&lt;strong&gt;Methods:&lt;/strong&gt; A study was conducted among 125 patients who attended the STI Clinic in a tertiary care center in a period of 6 months. Detailed history was taken along with complete physical examination and local examination.&lt;strong&gt;&lt;/strong&gt;&lt;/p&gt;&lt;p class="abstract"&gt;&lt;strong&gt;Results:&lt;/strong&gt; 125 patients attended the STI Clinic. Among them 75 patients [40 males and 35 females] were diagnosed to have Non venereal genital dermatoses. A total of 14 different non venereal dermatoses were observed in our study The commonest age group affected were in the age group of 30-40 year. The most common non-venereal dermatoses in females in our study were Lichen sclerosuset atrophicus and in males were fixed drug eruptions Pearly penile papules. Mild anxiety and concern about the genital lesions were found in almost all the males and females.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusions:&lt;/strong&gt; A prompt and correct diagnosis of non-venereal genital dermatoses needs a greater clinical acumen along with various investigative methods Patient must be treated as a whole rather than treating the disease alone. The complete successful outcome lies not only in treating the disease but also treating the patient as a whole allying his undue fears, stress and misconceptions. &lt;/p&gt;

A study of dermatoses in patients attending pediatric OPD in a tertiary care hospital of Gandhinagar, Gujarat, India

Background: Skin diseases in paediatric population are common all over the world. There is a wide variation in the presentation of Dermatoses in various studies. The variation among dermatoses can possibly be due to region of study, prevalent environmental factors, type of population studied, and hygiene and nutritional status and environmental factors. The objective of this study was to study prevalence, pattern of presentation and aetiologies of various dermatoses in paediatrics.Methods: A prospective, observational, single center study involving 500 patients of Dermatoses was carried out in a pediatric outpatient department. Detailed history, clinical presentation and other relevant parameter were recorded in a case record form and analyzed.Results: Majority of patients with dermatoses (39.40%) belong to age group of 6 - 16 years with male preponderance. Etiological analysis showed infections and infestations were most common dermatoses. Bacterial infection (184, 36.80%) was most common followed by viral (87, 17.40%), parasitic (51, 10.20%) and fungal (25, 5.00%) infection. Dermatitis was present in 30.6% patients. Diaper dermatitis (19 patients) was the commonest dermatitis present in infants while eczema and urticaria were the commonest dermatitis in school going children. Pyoderma was the commonest dermatoses in this study, present in 111 patients (22.20%) followed by varicella (14.40%), impetigo (12.80%); scabies (10.20%), eczema (10.20%) and urticaria (7.60%).Conclusions: Dermatoses in children are a wide spread problem which are responsible for significant morbidity in children. The high incidence of infections and infestations are possibly due to poverty, overcrowding, undernutrition, poor hygiene and lack of health education. Skin of the young children is more prone to develop skin disease.

Clinical Pattern of Dermatoses in Patients with Chronic Kidney Disease in Ile-Ife, Nigeria

Clinical Pattern of Dermatoses in Patients with Chronic Kidney Disease in Ile-Ife, Nigeria

In search of cutaneous marker for retinopathy in diabetic patients: A pilot study

Background: Diabetes mellitus is one of the most common causes of microangiopathy. Approximately 30% of all diabetics show skin lesions during their lifetime. However, there is a paucity of data on the association of diabetic retinopathy with the skin changes. Objectives: The aim is to study noninfectious diabetes associated dermatoses in patients with diabetic retinopathy and to compare the frequencies of dermatoses in diabetics with retinopathy, diabetics without retinopathy and nondiabetics. Materials and Methods: We screened 400 diabetic patients and found 145 diabetics with cutaneous manifestations were positive for diabetic retinopathy after fundoscopic examination by a qualified ophthalmologist. One hundred and forty-five age- and sex-matched diabetics with cutaneous manifestations and without retinopathy, and another 145 age- and sex-matched nondiabetics with normal random blood sugar (RBS) levels and cutaneous manifestations formed the control groups. Statistical analysis was performed using SPSS version 16 and Chi-square test. Results: Acquired ichthyosis was the most common finding which was seen in 70 (48.27%) diabetics followed by acrochordons in 18 (12.41%) diabetics. Other noninfectious dermatoses associated with Diabetic Mellitus seen among the cases include diabetic foot in 7 (4.8%), psoriasis in 5 (3.44%), acanthosis nigricans in 4 (2.75%), pruritus in 3 (2.068%), vitiligo in 3 (2.068%) patients, Kyrle's disease in 3 (2.068%), and diabetic bullae in 2 (1.37%) patients. Conclusions: Diabetic retinopathy is not an uncommon cause of ocular morbidity. Our observation calls for the need of a holistic approach toward the diagnosis and treatment of diabetes and diabetes-associated skin and systemic complications.

Study of pregnancy dermatoses in patients attending outpatient of B P Koirala Institute of Health Sciences, Dharan, Nepal

Background: Pregnancy causes immense hormonal, vascular and immunologic changes affecting every organ system including skin. It can have a positive as well as a negative effect on the course of pre-existing skin diseases. Specific dermatoses of pregnancy constitute a heterogenous group of inflammatory dermatoses associated exclusively with pregnancy. Objectives: To study the spectrum and frequency of pregnancy dermatoses and to compare the clinico- epidemiological profile of non-specific dermatoses among pregnant versus non-pregnant women of reproductive age.Material and Methods: This descriptive hospital based study recruited 300 patients with skin lesions; the test group comprised 150 pregnant ladies while the control group comprised 150 non-pregnant female of reproductive age. Demographic characteristics, medical history, examination findings, and relevant investigation reports were noted and diagnosis established. The patients of test group were then classified into distinct subgroups of dermatoses and were compared with non-pregnant patients of control group. Results: Specific dermatoses of pregnancy was very common (41.33%) in our study among which Prurigo of pregnancy was the commonest (24%). Inflammatory lesions were predominant in pregnant group (57.33%, p=&lt;0.001) whereas infectious diseases were predominant in the non-pregnants (44.67%). The demographic variables had no significant role in determining the distribution of any of the skin lesions in this study. Conclusion: Inflammatory lesions mostly specific dermatoses of pregnancy are found to be the commonest skin lesions among the pregnant ladies whereas infectious diseases are found to be comparable among pregnant and non pregnant ladies in our study.NJDVL Vol. 13, No. 1, 2015 Page: 38-44

Study of clinical spectrum of pediatric dermatoses in patients attending a Tertiary Care Center in North Kerala

Introduction: Skin diseases are a major health problem in the pediatric age group. Aim: To determine the prevalence and clinical characteristics of different pediatric dermatoses in a tertiary care centre in Kerala. Materials and Methods: Children with age 18 years and below with clinical evidence of cutaneous disorders were studied. Results: 500 cases were studied which showed a female preponderance of 51.4%. The most common dermatoses was infections and infestations (33.8%) followed by eczemas (32.6%), disorders of sweat and sebaceous glands (7.4%), keratinisation and paulosquamous disorders (4%). Nutritional disorders were seen in 1% of children. 3.6% had photodermatoses, 2.6% had hair and nail disorders and 0.4 % had adverse cutaneous drug reactions. Conclusions: Fungal infection was the most common infection noted in the study, followed by viral and bacterial infection. Allergic contact dermatitis was the commonest exogenous eczema and juvenile plantar dermatosis was the commonest endogenous eczemas. Acne, insect bite reaction and miliaria were the other common dermatoses.

Spectrum of cutaneous manifestations of type 1 diabetes mellitus in 500 south Asian patients

Data on cutaneous manifestations of type 1 diabetes mellitus (DM) is scarce. To study the spectrum of dermatoses in patients with type 1 DM and the effects of disease duration and long-term glucose control on these cutaneous manifestations. After prior consent, clinical examination and relevant investigations were done in 500 subjects with type 1 DM enrolled between July 2011 and June 2012. Statistical tests were performed using SPSS 16. The presence of various dermatoses was correlated with the duration of diabetes. Of five hundred subjects, 339 (67·8%) had one or more dermatoses. The mean age of the patients was 16·9 ± 6·9 years (range 1-25 years) and mean total duration of diabetes was 4·43 ± 4·4 years. Cutaneous adverse effects related to insulin injections (CAII), comprising lipohypertrophy (41%), post-inflammatory hyperpigmentation (3%), lipoatrophy (0·6%) and acanthosis nigricans (0·4%), were the most common findings, followed by limited joint mobility (LJM) (16·8%), xerosis (15·8%) and scleroderma-like skin changes (10%). Patients having long-duration DM (> 4·4 years) were significantly more likely to have lipohypertrophy (P = 0·000), LJM (P = 0·000), scleroderma-like skin changes (P = 0·000), diabetic dermopathy (P = 0·000), acanthosis nigricans (P = 0·005) and skin tags (P = 0·002). Lipohypertrophy, LJM and scleroderma-like skin changes also showed significant correlation with blood glucose level. Our study suggests that cutaneous changes are common in young Asian patients with type 1 DM. Information, education and counselling of patients and care givers, and awareness among physicians is essential for the prevention and early management of these dermatoses.

English

Diabetes mellitus (DM) refers to a group of common metabolic disorders that share the phenotype of hyperglycemia. The metabolic dysregulation associated with DM causes secondary pathophysiologic changes in multiple organ systems that impose a tremendous burden on the individual with diabetes and on the health care system. AIM: of the study was to evaluate presence and prevalence of common dermatoses in patients. 250 cases of D.M. with various cutaneous manifestations attending in and outpatient department of Dr. D. Y. Patil medical hospital were evaluated. Detailed history was taken as per proforma and patient investigated. Maximum incidence was seen between 40-70 yrs. of age and in middle class. Fungal infection constituted highest number which included dermatophytosis, candidiasis and pityriasis versicolor. No cutaneous reactions to therapy for diabetes were encountered in the present study.

Clinicoepidemiological study of skin manifestations in patients of chronic renal failure on hemodialysis

Background:Chronic renal failure (CRF) is associated with a variety of cutaneous manifestations as a result of underlying etiology as well as the various treatment modalities.Aim:To evaluate the prevalence of various dermatoses in patients with CRF on hemodialysis and to study the effect of hemodialysis on the intensity of pruritus.Materials and Methods:A total of 35 patients of CRF on hemodialysis having at least one cutaneous manifestation were included in the study.Results:Twenty-four (68.71%) cases in our study belonged to the age group of 50-69 years, out of which 16 cases were in the sixth decade. Xerosis and pruritus occurred in 80% and 65.71% of cases, respectively. Other common findings included pallor (68.57%), dyspigmentation (34.29%), cutaneous infections (34.39%), acquired perforating dermatosis (17.4%), and nail changes (60%). Hemodialysis failed to improve pruritus in 17 (73.9%) of our patients. Twenty-six patients (74.28%) suffered from hypertension, 13 of them also were known cases of type II diabetes mellitus. Five patients suffered exclusively from type II diabetes mellitus.Conclusions:In our small study, xerosis was the commonest finding and pruritus, the commonest symptom. The intensity of pruritus was largely unaffected by hemodialysis.

Classical Pyoderma Gangrenosum Associated with Abnormal Neutrophil Oxidative Burst

Pyoderma gangrenosum (PG) is a neutrophilic dermatosis characterized by soft tissue necrosis, most often in the lower extremities. Classical neutrophilic dermatoses in patients with chronic granulomatous disease (CGD) are rare. Here we describe an adult without a known diagnosis of CGD diagnosed with PG and a persistent defect in neutrophil oxidative burst.

Abstract 3039: Temporal Trends in the Prevalence of Dermatoses in Patients with Stroke and Transient Ischemic Attack in the United States

Background. We sought to determine the prevalence of skin conditions traditionally associated with acute ischemic stroke (AIS) and transient ischemic attacks (TIA) in the U.S. Methods. This is a cross-sectional study of data derived from the National Inpatient Sample from 1988-2008. We searched for admissions of patients &lt;18 years, with a primary diagnosis of AIS, TIA, and the following secondary diagnoses (dermatoses): Psoriasis, Behcet’s Disease (BD), Dermatomyositis (DM), Systemic Lupus Eythematosis (SLE), Pseudoxanthoma Elasticum (PXE), Progressive Systemic Sclerosis or Scleroderma (SCD), and Bullous Pemphigoid (BP). Definitions were based on ICD9CM codes, and adjusted incidence rates for the U.S census and prevalence proportions were then calculated. Results. Over the 20-year period, we identified 9,085,147 admissions that corresponded to a primary diagnosis of AIS and TIA of which 53,060 had a secondary diagnosis of dermatoses, for a total prevalence of 0.6%. The adjusted rate of AIS/TIA increased from 71/100,000 in 1988 to 200/100,000 in 2008. Among the secondary diagnosis, the most prevalent condition after AIS/TIA admissions was SLE (54%), psoriasis (34%), SCD (9%), BP (2%), DM (1%), PXE (0.5%), and BD (0.14%). The prevalence of these dermatoses increased from 0.2% in 1988 to 0.8% in 2008 ( Figure 1 ). Conclusion. Despite an overall increase in the prevalence of dermatoses, these skin conditions remain a rare occurrence in AIS/TIA. The over-representation of traditional risk factors for AIS/TIA in patients with these dermatoses, may explain the observed epidemiological phenomenon.

Acquired perforating dermatoses in patients with diabetic kidney disease on hemodialysis

Acquired perforating dermatoses (APD) is an uncommon skin disorder seen in patients with diabetes mellitus, chronic kidney disease, or both together. We present the clinicopathological features of APD in patients with diabetic kidney disease and discuss the recent advances in management. We retrospectively analyzed the data of 8 patients with APD presenting to our center. All patients were known cases of Type 2 diabetes and chronic kidney disease requiring maintenance dialysis. Acquired perforating dermatoses was diagnosed based on clinical presentation of itchy, keratotic papulonodular lesions, and characteristic histopathological features of transepithelial elimination on skin biopsy. The patients were subdivided into 4 types of APD based on the biopsy features. All our patients had Type 2 diabetes over 5 years duration and were on maintenance dialysis for more than 6 months before presentation. Acquired perforating dermatoses symptoms appeared 2 to 6 months before presentation. The majority of patients (6/8) had a subtype of reactive perforating collagenosis. All the patients showed significant resolution with topical glucocorticoid therapy. Acquired perforating dermatoses is a skin complication seen in Type 2 diabetes, chronic kidney disease, or when both are present together. Early identification and therapy prevents the associated morbidity.