Acquired perforating dermatosis: clinicopathological study of 31 cases, emphasizing pathogenesis and treatment

García‐Malinis, Ana Julia; Sánchez, E.; Sánchez-Salas, María Pilar; Prado, E Del; Coscojuela, C.; Gilaberte, Yolanda

doi:10.1111/jdv.14220

Cited by 59 publications

(104 citation statements)

References 40 publications

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“…The main cause of CKD was diabetic nephropathy, as in previous studies . Contrasting with other series, only 37.5% of the patients with CKD were receiving kidney replacement therapy . Although APD is scarcely reported in association with solid organ transplant, George et al reported a prevalence of 2.7% in a series of kidney transplant recipients .…”

Section: Discussionmentioning

confidence: 68%

“…Although hypertension and cardiovascular diseases were frequent comorbidities in this study, we hypothesize that these disorders were not the dominant factor implicated in the development of APD, given its high prevalence on overall population and the fact that almost all of the patients presented other underlying systemic diseases, in particular DM and CKD. However, García‐Malinis et al proposed that vasculopathy underlying chronic venous insufficiency and hypertension might be involved in the pathogenesis of APD …”

Section: Discussionmentioning

confidence: 99%

“…Acquired perforating dermatosis usually develops in adulthood in association with diabetes mellitus (DM) and chronic kidney disease (CKD), but many other systemic disorders have been recently reported …”

Section: Introductionmentioning

confidence: 99%

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Acquired perforating dermatosis: clinicopathologic study of a 10‐year period at a tertiary teaching hospital

et al. 2019

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Background Acquired perforating dermatosis (APD) comprises an uncommon group of skin disorders that develop in adulthood in association with systemic diseases. The aim of this study was to characterize clinicopathologic features and treatment outcomes in a series of patients diagnosed with APD. Methods Retrospective study of all patients diagnosed with an APD over a 10‐year period (2009–2018) at a tertiary teaching hospital in Lisbon, Portugal. Results Fifty‐seven patients with APD were identified. Thirty‐five patients presented lesions in multiple anatomic areas (61.4%), and the lower limbs were the most common location. Forty‐six patients reported pruritus (80.7%), which was classified as severe in 21 of them (36.8%). An underlying systemic disease was identified in 53 patients (93.0%). Diabetes mellitus (DM) and chronic kidney disease (CKD) were the most common associated systemic diseases, but psychiatric disorders, malignancies, and chronic infections were present in a significant number of patients. The combination of topical steroids with antihistamines was the most prescribed initial treatment, but only 37.8% of the patients had a complete response. Acitretin, systemic steroids, and phototherapy were the treatments associated with the best outcome. Conclusion Acquired perforating dermatosis can be associated with many systemic disorders that have pruritus as a common factor. Chronic viral infections and an occult malignancy should be sought, particularly in the absence of DM and CKD. The management of APD is challenging and is best achieved with the control of the underlying systemic diseases.

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Section: Discussionmentioning

confidence: 68%

Section: Discussionmentioning

confidence: 99%

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Acquired perforating dermatosis: clinicopathologic study of a 10‐year period at a tertiary teaching hospital

et al. 2019

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“…Advanced glycosylation end products in diabetes alter the differentiation of epidermal and dermal components leading to their transepidermal elimination 2. Diabetes-induced microangiopathy and dialysis-related microdeposition of exogenous agents may predispose to the APD 3. There are reports of improvement of skin lesions with the management of the underlying disorder 3.…”

mentioning

confidence: 99%

“…Diabetes-induced microangiopathy and dialysis-related microdeposition of exogenous agents may predispose to the APD 3. There are reports of improvement of skin lesions with the management of the underlying disorder 3. Topical steroids, retinoids and oral antihistamines are prescribed for localised lesions.…”

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confidence: 99%