To the Editor: Elastosis perforans
serpiginosa (EPS) is part of different kinds of perforating diseases that are dependent on factors such as idiopathic, reactive, or drug induced.
3,4,5,6) Scleromalacia perforans
and peripheral ulcerative keratopathy are other rare but frightening ocular complications.
Scleral manifestations of the disease include an anterior scleritis which may be diffuse, nodular, necrotizing or can present as scleromalacia perforans
or posterior scleritis which is uncommon.
Several different forms of perforating dermatoses exist, including reactive perforating collagenosis and the acquired perforating dermatosis diagnostic group (often associated with diabetes mellitus or chronic renal disease), which includes acquired reactive perforating collagenosis (RPC), elastosis perforans
serpiginosa, perforating folliculitis, and Kyrle's disease.
serpiginosa (EPS) is a rare skin disease generally involving the nape of the neck, face, upper and lower extremities, and trunk, occurring without sex predilection.
D-penisilaminin febril reaksi-yonlar, gastrointestinal sikintilar, karaciger disfonksiyonlaRI, tad alma duyusunda bozulma, kemik iligi baskilanmasi, metal eksiklikleri, membranoz glomerulopati, myastenia gravis ve cilt erupsiyonlarini (elastozis perforans
serpinginoza) iceren cok genis sayida yan etkileri vardir.
12-14) Furthermore, serious skin infections, for example folliculitis perforans
, cellulitis, and necrotizing fasciitis have also been reported.
Finally, perforating disorders with transepidermal elimination of elastin (elastosis perforans
serpiginosa, perforating folliculitis, perforating pseudoxanthoma elasticum) may resemble HLE, but these lesions contain neutrophils and histiocytes with fewer lymphocytes and typically do not demonstrate vacuolar interface changes (Figure 7, B).
It is usually very painful, with the exception of a necrotising form known as scleromalacia perforans
, which is painless and occurs in patients with longstanding rheumatoid arthritis.
10 Primary perforating disorders include Kyrle's disease, elastosis perforans
serpiginosa, perforating folliculitis and reactive perforating collagenosis.
Location may provide another clue to etiology: Ulcers located on the heel, the outside of the foot, or between the toes tend to be associated with vascular disease, while ulcers with surrounding callus, such as the classic mal perforans
ulcer on the metatarsal head, are neuropathic.
In 1934, Van der Hoeve (NGUYEN & FOSTER, 1999) first recommended the use of grafts in scleromalacia perforans
in human, using mucous membranes.