Kyrle's disease effectively treated with oral isotretinoin.

BACKGROUND

Kyrle's disease (KD) is a primary perforating dermatosis that affects more commonly 30-50 year old females, and clinically characterized by pruritic hyperkeratotic and ulcerated nodules, papules and plaques, localized on extensor surface of upper and lower limbs, and on the trunk.

OBJECTIVE

To determine the effectiveness of the treatment with oral isotretinoin in KD.

METHODS

We present the case of a 63-year-old woman with hyperkeratotic, erythematous-brown nodules and plaques localized on arms and legs, intensely itching; some lesions were ulcerated and discharging. Histology showed hyperplastic epidermis, cup-shaped invagination, degenerative basophilic material with plug formation. In the upper dermis, there was a dense lympho-histiocytic infiltrate. Narrow-band UVB and low dose oral corticosteroids were ineffective. Treatment with isotretinoin 20 mg/day was started with an excellent response in two months, and complete remission in the next four months. Isotretinoin was reduced to 10 mg/day for additional four months. In the next 9-month follow up, no recurrence of the disease was observed.

CONCLUSIONS

Low-dose isotretinoin was very effective and well tolerated in our patient. One previous case treated with isotretinoin has been published.