Skin Conditions associated with Diabetes can improve when Blood Sugar levels are Controlled (Kyrle’s disease is an example)

Take Home Message: Kyrle’s disease is a rare skin condition (perforating dermatosis) associated with diabetes mellitus and control of glycemia (in addition to Oral Vitamin A and anti-histamines) improved the condition. (Case report from the Philippines)

Comments

-Kyrle’s disease is a skin condition (perforating dermatosis) which is associated with diabetes mellitus.

-Like many other associated skin conditions, controlling glycemia (diet, oral antidiabetics, insulin) is shown to improve the condition

–Many skin conditions are associated with diabetes. The most frequent associations are infections (bacteria, yeast, fungal, parasites). To read more about Skin Problems in Diabetes, click HERE 

Abstract

Kyrle’s disease also known as Hyperkeratosis follicularis et parafollicularis in cutem penetrans is a rare acquired perforating dermatosis. This was first described by J. Kyrle in 1916.1-5 This is usually associated with an underlying systemic disease such as diabetes mellitus and chronic renal failure and usually presents as a pruritic generalized or scattered papules, nodules, follicular or parafollicular with central keratotic core usually on the legs. Extensor surfaces are favored over flexures usually with sparing of the mucous membrane and palmo-plantar surfaces. Histopathologic findings shows keratotic plug invaginating the epidermis, transepidermal elimination of keratotic material with no collagen or elastic fibers noted. We report a case of Kyrle’s disease in a 54-year-old, Filipino, female, known diabetic who presented with multiple well-defined erythematous to hyperpigmented nodules, papules some coalescing into plaques with central hyperkeratotic core on the trunk, upper and lower extremities with pruritus noted to be aggravated by poor glycemic control. Four-mm skin punch biopsy was done and showed findings consistent with Kyrle’s disease. Oral vitamin A, anti-histamine and good glycemic control were advised. Patient was noted to have symptomatic and clinical improvement in 8 weeks.

Reference: Regional Congress of Dermatology (RCD) 2016 – Singapore. RCD16-0285 Dermatopathology KYRLE’S DISEASE IN A 54-YEAR-OLD FILIPINO, FEMALE, TREATED WITH INSULIN AND ORAL VITAMIN A: A CASE REPORT E.M. Gutierrez1, D. King-Ismael1 1Jose R. Reyes Memorial Medical Center, Dermatology, Manila, Philippines