Gene/Protein Disease Symptom Drug Enzyme Compound
Pivot Concepts:   Target Concepts:
Query: UMLS:C0011849 (diabetes)
 277,896 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

We report on a 32-year-old female patient with chronic diabetes mellitus, type I, and chronic renal failure, who developed the typical clinical picture of hyperkeratosis follicularis et parafollicularis in cuteum penetrans (Kyrle's disease) within one year. Histological examination revealed a defective epidermal differentiation with hyper- and parakeratosis as well as premature keratinization as early as in the epidermal basal cell layer. Studies on lectin binding showed that the glycosylation process was impaired in both the epidermis and the basement membrane zone of the lesional skin. In addition, electron microscopic investigation revealed diabetic microangiopathy of the dermal vessels as well as marked ultrastructural alterations of the dermo-epidermal basal lamina. These findings confirm the association of diabetes mellitus with Kyrle's disease previously described; they make us suggest that Kyrle's disease might be characterized by a defective differentiation of the epidermis and the dermo-epidermal junction--due to some alteration of the underlying glycosylation processes--rather than by a local disorder of keratinization. Regarding the clinical manifestation of the disease, both diabetes mellitus and chronic renal failure may play a part as precipitating factors.
 ...
PMID:[Kyrle disease in juvenile diabetes mellitus and chronic renal failure]. 232 37

Patients with renal disease or diabetes mellitus often have an acquired perforating disease of the skin develop that is characterized by hyperkeratotic papules with transepidermal elimination of degenerated material, including collagen or elastic fibers. There is disagreement regarding the most appropriate name for this disease. The pathologic process has been identified by various authors as reactive perforating collagenosis, elastosis perforans serpiginosa, perforating folliculitis, or Kyrle's disease. We have seen four patients with renal disease and/or diabetes whose skin biopsy specimens demonstrated combined transepidermal elimination of both collagen and elastic fibers. This finding is not characteristically seen in any of the previously defined perforating diseases. Since the histologic findings vary greatly in different lesions from different patients with renal disease, we recommend referring to this process as "acquired perforating dermatosis." It is best not to create a new category of perforating disease or to say that a given patient has one of the other four diseases based on random sampling of only a few lesions.
 ...
PMID:Acquired perforating dermatosis. Evidence for combined transepidermal elimination of both collagen and elastic fibers. 1282 63

The diagnosis of Kyrle's disease is based on both clinical and histological findings. The penetration of the keratin plug into the dermis is no pathognomonic feature but the result of pathologic events. Kyrle's disease may be caused and promoted by association with other diseases going along with hyperkeratosis and causing damage to tissue proteins by non-enzymatic glycosylation (e. g., diabetes mellitus and renal failure).
 ...
PMID:[Kyrle's disease in diabetes mellitus and chronic terminal kidney failure]. 375 Dec 14

We believe that the disease we are reporting is associated with diabetes, particularly in patients on renal dialysis, and the perforation is initiated by scratching. Decreasing pruritus is the only needed treatment as the lesions tend to resolve on their own. While this entity has been called Kyrle's disease, it more correctly is reactive perforating collagenosis, both clinically and histologically. Whether this is a variant of what Kyrle originally described is not clear. We propose that this entity be called reactive perforating collagenosis of diabetes and renal failure.
 ...
PMID:Reactive perforating collagenosis of diabetes mellitus and renal failure. 682 59

We have noticed in eight male patients transepithelial keratotic plugs which appeared preferentially on zones of supporting points. These plugs evoked in a more or less accurate way, Kyrle's disease or other related syndromes, particularly reactive perforating collagenosis and perforating folliculitis. Seven cases were associated with chronic and severe renal failure complicating a serious diabetes in four cases, one of them with a viral hepatitis. One case has been observed during an important denutrition with digestive disorders.
 ...
PMID:[Hyperkeratosis of the keratotic plug type in patients with chronic renal failure and metabolic diseases]. 713 95

Pyomyositis, an endemic disease of tropical origin, is increasingly reported in temperate zones, especially in patients with diabetes mellitus and in the immunocompromised. A 28-year-old renal transplant recipient presented with perforating skin lesions (Kyrle's disease), thigh pain, and swelling associated with fever. A gallium scan of the thigh led to surgical exploration and a diagnosis of pyomyositis. To our knowledge, the association of Kyrle's disease with pyomyositis has not been reported before. The significance of this combination of conditions in our patient remains unexplained.
 ...
PMID:Pyomyositis in a renal transplant patient with Kyrle's disease. 885 70

Perforating disorders represent a heterogenous group of dermatoses characterized by transepithelial elimination of dermal structures. Primary perforating disorders should be distinguished from secondary perforating disorders in which perforation with transepithelial elimination is a rare component of a variety of dermatoses. The primary perforating disorders are hyperkeratosis follicularis et parafollicularis in cutem penetrans (Kyrle's disease), elastosis perforans serpiginosa and perforating folliculitis. Acquired reactive perforating dermatosis (also known as acquired reactive perforating collagenosis) together with the hereditary variant of the reactive perforating collagenosis represent further examples of the primary perforating disorders. We report on 84 year old and 96 year old female patients with an acquired perforating dermatosis. Both of the patients additionally showed diabetes and hyperuricemia. Oral administration of allopurinol (100 mg daily) led to a healing of the disseminated skin lesions in 1-2 weeks. After a follow-up period of 6 months, both patients were in complete remission. On one hand, these results prove again the existence and the severity of this disease, and on the other hand suggest an immunomodulating or differentiation-promoting action in addition to the uricostatic effect of allopurinol.
 ...
PMID:[Acquired reactive perforating dermatosis. Successful treatment with allopurinol in 2 cases]. 1009 54

We describe here in a case of a 41-year-old man, with diabetes mellitus, who presented manifestations of Kyrle's disease. Administration of metronidazole, 500 mg twice daily for 1 month, resulted in complete regression of skin lesions with no recurrence during 12 months of follow-up. This successful antibiotic treatment is to support the role of infectious agents (anaerobic bacteria) in the pathogenesis of Kyrle's disease.
 ...
PMID:Regression of skin lesions of Kyrle's disease with metronidazole in a diabetic patient. 1790 37

Kyrle's disease (KD) is a dermatosis which was first described by Kyrle as "hyperkeratosis follicularis et parafollicularis in cutem penetrans" in 1916. Perforating dermatoses are a heterogeneous disorder group characterised by transepithelial elimination. KD has been seen in association with multiple disorders, including diabetes mellitus, renal and liver diseases, congestive heart failure, hyperlipidaemia, infective diseases and abnormal metabolism of vitamin A. This case report presents two patients with KD with associated systemic disease.
...
PMID:Kyrle's disease. 2442 45

Kyrle's disease (KD) is an acquired perforating dermatosis associated with an underlying disorder such as diabetes mellitus or chronic renal failure. It presents as multiple discrete, eruptive papules with a central crust or plug, often on the lower extremities. A keratotic plug is seen histologically in an atrophic epidermis and may penetrate the papillary dermis with transepidermal elimination of keratotic debris without collagen or elastic fibers. Various therapies have been reported that include cryotherapy, laser therapy, narrow-band ultraviolet B and use of topical or systemic retinoids. Hereby a case of 64-year-old male, a known case of diabetes mellitus, hypertension and chronic renal failure who developed KD is presented.
...
PMID:Kyrle's disease in a patient of diabetes mellitus and chronic renal failure on dialysis. 2594 85


1 2 Next >>