PAPULO-NODULES LOCATED TO BOTH LOWER EXTREMITIES
Perforating diseases are characterized by transepidermal elimination of degenerated material, including collagen or elastic fibers. Acquired perforating dermatosis affects patients with diabetes mellitus or renal disease, especially under dialysis. An 86-year-old diabetic patient presents with very pruritic erythematous-violaceus papules and papulo-nodules, with a central crust. Lesions were evoluting for 2 months and were located to both lower extremities. The biopsy revealed a depression with fibrinous material and picnotic cells. Van-Gieson coloration showed elimination of vertical collagen bundles. The patient was treated with topical retinoid, with complete resolution.
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