Kyrle's disease (KD) is a dermatosis which was first described by Kyrle as "hyperkeratosis follicularis et parafollicularis in cutem penetrans " in 1916. Perforating dermatoses are a heterogeneous disorder group characterised by transepithelial elimination. KD has been seen in association with multiple disorders, including diabetes mellitus, renal and liver diseases, congestive heart failure, hyperlipidaemia, infective diseases and abnormal metabolism of vitamin A. This case report presents two patients with KD with associated systemic disease. Copyright 2014 BMJ Publishing Group. All rights reserved.