Kyrle's Disease with Diabetes Meuxfus and Chronic Renal Failure

A 54 year old male had Kyrle's disease manifestion as multiple, discrete papules with cone-shaped keratotic plugs. The lesions were severly pruritic and located symmetrically on the extensor aspects of the limbs and the trunk. Histopatholggical examination confirmed the diagnosis. The patient was known to be diabetic for 18 years and developed chronic renal failure 4 months prior to the onset of the skin lesions. Treatment with 6% salicylic acid topically did not produce any improvement of the lesions.