An Unusual Case of Kyrle Disease

Kyrle disease is one of the acquired perforating disorders (APDs), commonly associated with type 2 diabetes, chronic kidney disease, and other pruritic conditions. Here, we report a case of Kyrle disease with characteristic transepidermal elimination of dermal contents on histopathology. However, the only abnormal laboratory finding in our patient was hyperuricemia, and none of the commonly associated underlying conditions were found. The precise etiopathogenesis of APD is poorly understood. Abnormal glycation of collagen in diabetes and defective follicular keratinization following chronic friction have been commonly implicated in the pathogenesis. Treatment of the underlying cause is the mainstay; however, our patient responded well to acitretin, dapsone, and topical corticosteroids. Further studies need to be done to evaluate other possible causes, such as hyperuricemia in our patient, especially when none of the classical associations are present after a detailed workup.