Dermatosis Perforante Adquirida / Acquired perforating dermatosis

RESUMEN

RESUMEN Los trastornos perforantes constituyen un grupo de enfermedades caracterizadas por la extrusión transepidérmica de material dérmico. La etiopatogenia es desconocida, sin embargo, la forma adquirida generalmente se presenta asociada a enfermedades sistémicas como insuficiencia renal y diabetes mellitus, entre otras. El prurito es el síntoma cardinal de esta patología, y clínicamente presenta pápulo-nódulos centrados por costras queratósicas. En cuanto al tratamiento, la dermatosis perforante adquirida (DPA) es de difícil control, con tendencia a la cronicidad. Presentamos el caso de una paciente de género femenino de 57 años de edad, con antecedente de diabetes,hipertensión arterial (HTA), hipotiroidismo e insuficiencia renal, con prurito generalizado de varios meses de evolución.

ABSTRACT

ABSTRACT Perforating disorders are a group of diseases characterized by transepidermal extrusion of dermal material, it includes reactive perforating collagenosis, perforating folliculitis, elastosis perforansserpiginosa and Kyrle's disease, and in recent years the term acquired perforating dermatosis (APD) has been used to refer to the perforating dermatoses that occur in adult patients associated with systemic disorder (kidney failure, diabetes mellitus, hypothyroidism, among others). The etiopathogenesis is still controversial and it is believed that several factors participate in the process, such as traumatism produced by chronic pruritus in predisposed patients, diabetic microangiopathy may contribute to collagen damage and to the microdeposition of substances that are no removed by dialysis, causing local inflamatory reaction. The itching constitudes the main symptom of this pathology, and clinically presents a papulo-nodules centered by keratosis crusts. Differential diagnoses include nodular prurigo, multiple keratoacanthomas, sarcoid, and other perforating dermatosis. Treatment is difficult, with great tendency to chronicity. We report the case of a 57 year-old female patient, with history of type 2 diabetes, hypothyroidism and renal failure, with itching of several months of evolution.