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Dtsch Med Wochenschr. 2007 Dec;132(49):2624-6.

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

[Article in German]

Author information

  • 1Universitätsklinik und Poliklinik für Dermatologie und Venerologie der Martin-Luther-Universität Halle-Wittenberg.

Abstract

HISTORY:

A 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.

INVESTIGATIONS:

Laboratory 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.

CONCLUSION:

Acquired 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.

[PubMed - indexed for MEDLINE]
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