Summary Cutaneous manifestations of Chronic Renal Failure (CRF) include pruritus, diffuse hyperpig-mentation xerosis, follicular hyperkeratosis, ‘uremic frost’, bullous dermatosis similar tn hepato-cutaneous porphyria, skin calcifications and half-and-half nails. A series of cases have been described recently which had severe follicular hyperkeratosis, located primarily on the extension surface of the lower limbs, a number of which were pruritic. The authors differed in their interpretations of the condition. Some considered it to be Kyrle's disease, and others perforating folliculitis. We believe that this condition is a new dermatologic disorder, probably secondary to uraemia, which has clinical characteristics distinguishing it from both Kyrle's disease and perforating folliculitis. In this paper, we give our observations and a review of the relevant literature supporting our opinion.