Viejo-Boyano Iris, López-Romero Luis Carlos, Martínez-I-Cózar Vicent, Soldevila-Orient Amparo, Hernández-Jaras Julio
Nephrology Department, University and Polythechnic La Fe Hospital, Valencia, Spain.
Pathological Anatomy Department, University and Polythechnic La Fe Hospital, Valencia, Spain.
AME Case Rep. 2023 Oct 12;7:46. doi: 10.21037/acr-23-9. eCollection 2023.
Acquired perforating dermatosis (APD) is a heterogeneous group of unfrequented diseases (2.5 cases for 100,000 habitants) associated with multiple pathologies like end-stage renal disease and other concomitant conditions such as diabetes mellitus (DM).
We described 3 cases of APD in patients on peritoneal dialysis (PD), one of them with a giant variant of reactive perforating collagenosis (RPC). The first case is a 28-year-old man with chronic kidney disease on PD and a lousy control of disturbances of calcium and phosphorus metabolism that develops an APD. The second case is a 44-year-old man with DM, chronic kidney disease (CKD) on PD, and poor control of disturbances of calcium and phosphorus metabolism that develops an RPC. The third case is a 58-year-old man with DM, rheumatoid arthritis, hypothyroidism, CKD and bad control of calcium and phosphorus metabolism that develops a giant variant of RPC with poor evolution.
CKD and concomitant conditions such as DM present an increased risk of developing APD. Poor control of calcium and phosphorus metabolism is frequently found in patients with CKD and seems to be related to the development of APD in our cases. With the description of these cases, we want to emphasize the importance of knowing this rare disease, in order to promptly refer to Dermatology and start treatment.
获得性穿通性皮肤病(APD)是一组少见的异质性疾病(每10万居民中有2.5例),与多种病理状况相关,如终末期肾病以及其他伴随疾病,如糖尿病(DM)。
我们描述了3例腹膜透析(PD)患者的APD病例,其中1例为反应性穿通性胶原病(RPC)的巨大型变体。第一例是一名28岁男性,患有慢性肾病且接受PD治疗,钙磷代谢紊乱控制不佳,发生了APD。第二例是一名44岁男性,患有DM、慢性肾病(CKD)且接受PD治疗,钙磷代谢紊乱控制不佳,发生了RPC。第三例是一名58岁男性,患有DM、类风湿关节炎、甲状腺功能减退、CKD,钙磷代谢控制不佳,发生了RPC的巨大型变体且病情进展不佳。
CKD以及DM等伴随疾病会增加发生APD的风险。CKD患者中经常发现钙磷代谢控制不佳,在我们的病例中似乎与APD的发生有关。通过对这些病例的描述,我们想强调了解这种罕见疾病的重要性,以便及时转诊至皮肤科并开始治疗。