Reactive perforating collagenosis of diabetes mellitus and renal failure

We believe that the disease we are reporting is associated with diabetes, particularly in patients on renal dialysis, and the perforation is initiated by scratching. Decreasing pruritus is the only needed treatment as the lesions tend to resolve on their own. While this entity has been called Kyrle's disease, it more correctly is reactive perforating collagenosis, both clinically and histologically. Whether this is a variant of what Kyrle originally described is not clear. We propose that this entity be called reactive perforating collagenosis of diabetes and renal failure.