• Dtsch. Med. Wochenschr. · Dec 2007

    Case Reports

    [Acquired reactive perforating collagenosis associated with diabetes mellitus and renal insufficiency requiring dialysis].

    • R Nebel, E Fiedler, B Danz, W C Marsch, and B Kreft.
    • Universitätsklinik und Poliklinik für Dermatologie und Venerologie der Martin-Luther-Universität Halle-Wittenberg.
    • Dtsch. Med. Wochenschr. 2007 Dec 1; 132 (49): 2624-6.

    HistoryA 60-year-old man with diabetes mellitus and chronic renal insufficiency needing hemodialysis was admitted with a 3 months history of multiple hyperkeratotic papules on the trunk and extremities partly ulcerated with a keratotic central plug.InvestigationsLaboratory tests revealed elevated levels of blood urea nitrogen, creatinine, and HbA (1c). Histopathology showed vertical strands of collagen perforating from the ulcerated lesions. COURSE, DIAGNOSIS AND TREATMENT: The biopsy specimen was consistent with acquired reactive perforating collagenosis. The progression was stopped and secondary wound healing was initiated after two weeks of therapy with allopurinol and PUVA.ConclusionAcquired reactive perforating collagenosis should be considered when ulcera with oystershell-like keratotic plugs are found especially in patients with predisposing diseases like diabetes and renal insufficiency. A good interdisciplinary cooperation between internist and dermatologist is crucial for the early recognition by histopathology and the immediate treatment.

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