Introduction: This is the second case of persistent acantholytic dermatosis in a patient with chronic renal failure, seen at the same institution in 2 years.
Clinical picture: A 70-year-old Chinese man with end-stage renal failure on continuous ambulatory peritoneal dialysis for 6 months presented with pruritic rashes over the scalp and chest for 3 months. Histologically, the lesions resembled Darier's disease. Differential diagnoses include Darier's disease, Grover's disease and perforating dermatosis in chronic renal failure.
Treatment: The patient was treated with anti-histamines, topical steroids and emollients.
Outcome: Resolution of pruritus was documented. However, the extensive hyperkeratotic papules remained persistent.
Conclusion: A chronic non-remitting course is to be expected for this dermatoses in which the aetiology is unknown.