This protocol covers acquired perforating dermatosis presenting as acquired reactive perforating collagenosis — a condition defined by transepidermal elimination of collagen fibers, with onset of skin lesions after the age of 18 years.

Clinical Scenario

Acquired reactive perforating collagenosis is characterised by transepidermal elimination of collagen fibers. The established diagnostic criteria require all three of the following: histopathological elimination of necrotic basophilic collagen tissue into a cup-shaped epidermal depression; clinical presentation of umbilicated papules or nodules with a central adherent keratotic plug on the skin; and onset of skin lesions after the age of 18 years.

Treatment Approach

The structured regimen for this presentation involves topical steroid therapy. Where coexisting diabetes and chronic kidney disease are present, their treatment is also incorporated as part of the overall approach.

Full regimen, sequencing, and evidence summary available below →

References

DOI: 10.1111/1346-8138.15647

Acquired reactive perforating collagenosis presents with transepidermal elimination of collagen fibers.

In 1994, Faver et al. published the diagnostic criteria as meeting all of the following: (i) histopathological findings of elimination of necrotic basophilic collagen tissue into a cup-shaped epidermal depression; (ii) clinical presentation of umbilicated papules or nodules with a central adherent keratotic plug; and (iii) onset of skin lesions after the age of 18 years.

We suggest considering topical steroid therapy as a treatment for acquired reactive perforating collagenosis.

We suggest considering the treatment of coexisting diabetes and chronic kidney disease as a treatment for acquired reactive perforating collagenosis.

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Treatment of Acquired Perforating Dermatosis in Acquired Reactive Perforating Collagenosis with Coexisting Diabetes and Chronic Kidney Disease

Clinical Scenario

Treatment Approach

References