Mackie, "Transepidermal elimination of urate-like crystals: A new
perforating disorder?" British Journal of Dermatology, vol.
The results were consistent with a perforating disorder.
In contrast to other perforating disorders, the extruded material is predominantly keratin rather than elastic fibers or collagen.
Histologic analysis suggested a
perforating disorder but could not rule out skin cancer.
Acquired reactive
perforating disorder associated with chronic kidney disease.
Perforating disorder (Kyrle's disease RPC 31 (8.9%)###17 (9.1%)###14 (8.5%)
They generally appear after the primary disease has developed, but may signal or appear coincidentally with its onset, or even precede diabetes by many years.10 Cutaneous manifestations of diabetes are classified into four categories: skin lesions with a strong-to weak association with diabetes (necrobiosis lipoidica, diabetic dermopathy, diabetic bullae, yellow skin, eruptive xanthomas,
perforating disorders, acanthosis nigricans, oral leucoplakia, lichen planus); infections (bacterial, fungal); cutaneous manifestations of diabetic complications (microangiopathy, macroangiopathy, neuropathy); and skin reactions to diabetic treatment (sulfonylureas or insulin).11
Cutaneous manifestations of diabetes are classified into four categories: Skin lesions with strong-to-weak association to diabetes (necrobiosis lipoidica, diabetic dermopathy, diabetic bullae, yellow skin, eruptive xanthomas,
perforating disorders, acanthosis nigricans, oral leucoplakia, lichen planus), infections (bacterial, fungal), cutaneous manifestations of diabetic complications (microangiopathy, macroangiopathy, neuropathy) and skin reactions to diabetic treatment (Sulphonylureas or insulin).
Other entities with exuberant pseudoepitheliomatous hyperplasia not typically considered interface processes may rarely enter the differential, including deep fungal infections, the halogenodermas (bromoderma, iododerma), and some
perforating disorders. It cannot be overemphasized that rigorous clinicopathologic correlation is the key to avoiding misdiagnosis of HLE as squamous neoplasia or another hypertrophic lichenoid dermatitis.
Skin diseases that were studied and evaluated are detailed in Table 1 but also included the following:
perforating disorders; calciphylaxis; porphyria and pseudoporphyria; onychomycosis; clubbing; horizontal nail ridging; Terry's nail; hypersensitivity rashes; and malignant skin lesions.
Xerosis, pruritus, half-and-half nails, cutaneous hyperpigmentation, pallor and
perforating disorders are common manifestations of ESRD.6
The
perforating disorders. J Am Acad Dermatol 1984; 10: 561-81.
