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A pronounced hyperkeratosis is characteristic with the formation of horny cones that penetrate into the epidermis, both in the area of valtrex pills follicles and outside them.
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In some areas, horny masses violate the integrity of the epidermis and penetrate into the skin itself, which causes the formation of granulomas consisting of lymphocytes, fibroblasts, epithelioid cells and a significant number of giant cells of foreign bodies; epidermis along the circumference of the horny cone in a state of acanthosis (Fig. 1).

The primary element is a follicular, less often parafollicular horny nodule the size of a pinhead, yellowish in color; as the nodules increase, they gradually acquire a brown-red color and a warty appearance due to horny usloeny. When the nodules merge, plaques of various sizes are formed, which mostly have polycyclic outlines (Fig. 2). After removal of the horny layers, sometimes consisting not only of scales, but also of scaly crusts, funnel-shaped depressions are found under them, slightly weeping, less often bleeding.

Healing occurs with superficial scars, pigmentation temporarily remains.

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The lesion is usually localized on the extensor surface of the extremities, but sometimes has a disseminated character involving the scalp, face, trunk, and very rarely the oral mucosa. The course is chronic, sometimes with relapses. The general condition of the patients is not disturbed, there is no itching.

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The diagnosis is not always easy to establish. From warty red flat depriving To. differs by the absence of itching and primary rash typical of lichen planus (see Lichen planus). From red hairy depriving To. is distinguished by the absence of the so-called Besnier's cones on the back of the phalanges of valtrex pills, the presence of polycyclic foci, the possibility of easy removal of horny layers. According to the wedge, K.'s picture. may resemble Darier's disease (see Darier's disease), differing from it by the presence of funnel-shaped depressions after removal of horny masses.

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In doubtful cases resort to gistol, a research: the phenomena of a dyskeratosis for To. are not typical. It should be noted that in exceptionally rare cases, the penetration of horny masses into the skin proper (Kirle phenomenon) also occurs in some other diseases. Long-term use of vitamin A, Keratolytic ointments, ointments with retinoic acid (vitamin A), subsequent UV irradiation; individual foci can be removed surgically, by methods of diathermocoagulation, cryotherapy (liquid nitrogen).

Kirle's disease is a rare chronic skin disease belonging to the group of keratoses, manifested by a violation of keratinization in the follicle zone.

A synonym for Kirle's disease: follicular and parafollicular hyperkeratosis penetrating the skin.

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The etiology is unknown. The genetic nature of dermatosis is assumed. Great importance is also attached to the violation of vitamin A metabolism, disorders of carbohydrate metabolism. A pronounced hyperkeratosis is characteristic with the formation of valacyclovir pills cones that penetrate into the epidermis, both in the area of ​​\u200b\u200bthe hair follicles and outside them.

In some areas, horny masses violate the integrity of the epidermis and penetrate into the skin itself, which causes the formation of valtrex generic pills, consisting of lymphocytes, fibroblasts, epithelioid cells, and a significant number of giant cells of foreign bodies. The epidermis around the circumference of the horny cone is in a state of acanthosis. In the subcutaneous adipose tissue - cell infiltration, the appearance of acid mucopolysaccharides, a decrease in the number of elastic fibers. Kirle's disease develops at any age, but more often in boys 10-12 years old.

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After removal of the horny layers, sometimes consisting not only of scales, but also of scale-crusts, funnel-shaped depressions are found under them, slightly weeping, less often - bleeding. Healing occurs with the formation of superficial scars, pigmentation temporarily remains.

As a rule, the extensor surfaces of the extremities are affected, but sometimes the skin lesion is disseminated, involving the scalp, face, trunk, and, very rarely, the oral mucosa.

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The course of Kirle's disease is chronic, sometimes with relapses.

Kirle's disease differs from lichen pilaris in the absence of the so-called Besnier cones on the back of the phalanges of the fingers, the presence of polycyclic foci, and the possibility of easy removal of horny layers. According to the clinical picture, Kirle's disease may resemble Darier's disease, differing from it by the presence of valtrex pills depressions after removal of horny masses. In doubtful cases, they resort to a histological examination: the phenomena of dyskeratosis are not typical for Kirle's disease.

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The general condition of the patients is not disturbed, there is no itching. Differential diagnosis. The diagnosis is not always easy to establish. Kirle's disease differs from verrucous lichen planus in the absence of itching and primary rash typical of lichen planus.

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