FDG PET/CT findings in acquired perforating dermatosis

Area of Science:

• Dermatology
• Nuclear Medicine
• Nephrology

Background:

• Acquired perforating dermatosis (APD) is a rare disorder characterized by transepidermal elimination of dermal components.
• Patients undergoing hemodialysis are at increased risk for various dermatological conditions.
• Diagnostic challenges arise when APD presents with atypical symptoms or in specific patient populations.

Observation:

• A hemodialysis patient presented with a skin eruption and jaundice, prompting investigation for biliary malignancies.
• Fluorodeoxyglucose Positron Emission Tomography/Computed Tomography (FDG PET/CT) was performed to evaluate for malignancy.
• The PET/CT scan revealed multiple, intensely FDG-avid nodules in the skin, with no significant abnormal uptake elsewhere.

Findings:

• Histopathological examination of the skin eruption confirmed the diagnosis of acquired perforating dermatosis (APD).
• This is the first reported case detailing the FDG PET/CT imaging characteristics of APD.
• The cutaneous nodules demonstrated significant fluorodeoxyglucose (FDG) avidity on PET/CT.

Implications:

• The findings suggest that APD should be considered in the differential diagnosis of patients on hemodialysis presenting with multiple cutaneous FDG accumulations on PET/CT.
• FDG PET/CT may reveal characteristic findings of APD, aiding in diagnosis when malignancy is suspected.
• This case expands the understanding of APD's imaging features and its potential presentation in patients with chronic kidney disease.