A case of Kyrle's disease successfully treated with topical benzoyl peroxide

This study reports a case of 46-year-old Japanese man with Kyrle's disease successfully treated topical benzoyl peroxide (BPO). Topical BPO, along ozenoxacin, were initially administered. The latter was discontinued after 4 weeks, while BPO continued to be administered, as the patient's lesions had flattened. His skin almost fully resolved 5 months. Perforating dermatoses consist heterogeneous entities characterized by transepidermal elimination various dermal materials. Classical perforating are divided into four types: acquired reactive collagenosis, elastosis perforans serpiginosa, disease, and folliculitis.1 There is no standard therapeutic protocol for dermatoses, although therapies have been tried. Here, we report A referred us itchy papules nodules on extremities. appeared 20 months before first visit diagnosed folliculitis. Physical examination revealed pruritic hyperpigmented central umbilication keratotic plugs extremities buttocks (Figure 1A-C). These also observed linear distribution trunk, suggesting existence Köbner phenomenon 1B). medical history included type 1 diabetes mellitus, diabetic nephropathy, renal failure, he undergone hemodialysis. Histopathology biopsy specimen from papule in one his lower showed acanthosis hyperkeratosis keratin plug inflammatory debris composed mostly neutrophils filling an epithelial invagination 1D,E). Elastica van Gieson staining did not reveal collagen or elastic fibers 1F). definitive diagnosis established. partly accompanied folliculitis, coagulase-negative Staphylococcus isolated using swab culture. ozenoxacin administered based treatment acne. agents improved findings discontinued. because gradually After months, resolved, post-inflammatory hyperpigmentation 1G). commonly manifests pruritic, red-brown papules, plugs. phenomenon, which occurs secondary scratching, has often observed. To date, treatments that reported literature include antibiotics, immunosuppressants, phototherapy, topical/systemic retinoids, keratolytics, well multiple combination regimens incorporate use oral/topical/injectable steroids, emollients, and/or antihistamines.2 associated underlying systemic disorders, such chronic failure proper management disorders required control itch-scratch cycle. However, guidelines evidence-based developed, recommendation can made.2 only collagenosis refractory corticosteroid oral antihistamine but responded satisfactorily BPO.3 Benzoyl acts antibacterial suppressing Propionibacterium acnes sebaceous follicle anti-inflammatory acne.4 It still remains unclear whether anti-itch effects disease. penetrated pores removed plugs, led clinical improvement our case. Further studies confirm efficacy authors declare conflicts interest. Approval research protocol: No human participant involved this study. Informed Consent: Patient provided informed consent publication images submitted article. Registry Registration No.: N/A Animal Studies: data support available corresponding author, Koji Kamiya, upon reasonable request.