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A 46-year-old man with diabetes and renal failure. Follicular keratotic papules consistent with acquired perforating dermatosis were distributed diffusely over his legs (A) and buttocks (B). Skin biopsy (C) showing a hair follicle with perforation extending into the dermal tissue which contains a tract of necrotic tissue debris with degenerate elastin fibres (hematoxylin–eosin stain, original magnification ×40).
