Acquired Reactive Perforating Collagenosis - A Rare Entity Occurring Within Common Disorders - A Systematic Review and Our Personal Experience

Sep 30, 2026

Uploaded by hdkawk

Acquired reactive perforating collagenosis (ARPC) is a rare condition in adults, often associated with systemic diseases including diabetes mellitus, chronic kidney disease, cardiovascular diseases, and malignancies, while drug- and trauma-related cases have also been reported. Because optimal management lacks consensus, a systematic review was performed to compile current diagnostic and therapeutic insights, and an additional case of ARPC linked to CKD was presented.

LanguageEnglish

CategoryHealthcare

FormatPDF

Pages13

Reading Time33 min

AccessFree to download

Introduction

Methods

PRISMA 2020 approach

Literature search (PubMed, May–September 2025)

Results

Study selection and patient characteristics

Clinical suspicion and diagnostic tools

Conclusion

Evaluation for underlying diseases

Need for clinical trials

Systematic Review Acquired Reactive Perforating Collagenosis—A Rare Entity Occurring Within Common Disorders: A Systematic Review and Our Personal Experience Maria Alexandra Junghetu 1,2, Cristina Violeta Tutunaru 3, *, Simona Laura Ianos, i 3, Claudia Valentina Georgescu 4 and Olgua Anca Orzan 1,2 Academic Editors: Alexander C. Katoulis and Alan Fleischer Received: 3 November 2025 Revised: 19 December 2025 Accepted: 27 December 2025 Published: 5 January 2026 Copyright: © 2025 by the authors. Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license. 1 Department of Oncologic Dermatology,“Carol Davila” University of Medicine and Pharmacy, 020021 Bucharest, Romania; [maria-alexandra.junghetu0425@rez.umfcd.ro](maria-alexandra.junghetu0425@rez.umfcd.ro) (M.A.J.); [olguta.orzan@umfcd.ro](olguta.orzan@umfcd.ro) (O.A.O.) 2 Department of Dermatology, Elias University Emergency Hospital, 011461 Bucharest, Romania 3 Department of Dermatology, Faculty of Medicine, University of Medicine and Pharmacy of Craiova, 200349 Craiova, Romania; [simonaianosi@hotmail.com](simonaianosi@hotmail.com) 4 Department of Pathology, University of Medicine and Pharmacy of Craiova, 200349 Craiova, Romania; [cgeorgescu2001@yahoo.com](cgeorgescu2001@yahoo.com) * Correspondence: [crisbej@yahoo.com](crisbej@yahoo.com) Abstract Background/Objectives: Acquired reactive perforating collagenosis (ARPC) is a rare entity usually occurring in adults with systemic diseases such as diabetes mellitus, chronic kidney disease (CKD), cardiovascular diseases, and malignancies, although drug-related and trauma-induced cases have also been reported. Given its rarity and the lack of consensus on optimal management, we conducted a systematic review to summarize updated diagnostic and therapeutic insights into ARPC. Additionally, we report a case of ARPC associated with CKD. Methods: This study was conducted in accordance with the PRISMA 2020 (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines. A literature search was performed in the PubMed database between May–September 2025 . The search strategy targeted open-access, primary human studies, published within the last 15 years, available in English, and including adult patients with histopathologically confirmed ARPC. Results: Twenty-seven studies, predominantly case reports and case series, were included. The mean patient age was 60.8 ± 14.4 years. Only one case occurred in the absence ofcomorbidities, while most subjects had underlying systemic diseases. Drug-induced cases were also described. Clinically, ARPC should be suspected in patients presenting with pruritic papules/nodules with central keratotic plugs. Additional diagnostic tools include dermoscopy and reflectance confocal microscopy. However, histopathological evidence of transepidermal elimination of altered collagen fibers is mandatory. The current treatments of ARPC include antihistamines, keratolytics, topical/intralesional/oral corticosteroids, topical/systemic retinoids, phototherapy, dupilumab and allopurinol. Other therapies have been reported across the literature, including emerging ones. Conclusions: Once ARPC is diagnosed, a thorough evaluation for underlying diseases, including malignancies, is essential. Clinical trials are warranted to define optimal therapeutic strategies. Keywords: acquired reactive perforating collagenosis; perforating diseases; acquired perforating dermatosis 1. Introduction Acquired reactive perforating collagenosis (ARPC) is a subtype of the perforating disorders, characterized by transepidermal expulsion of altered collagen bundles [1–5] . This entity occurs in adults, mostly middle-aged, with systemic diseases such as diabetes mellitus (DM) or end-stage renal disease (ESRD), although an association with malignancies, drugs or skin trauma has been desc

FAQs

What is acquired reactive perforating collagenosis (ARPC) and who is it seen in?

ARPC is a perforating disorder involving transepidermal expulsion of altered collagen bundles. It occurs mainly in adults, often with systemic diseases such as diabetes mellitus and end-stage renal disease.

How is ARPC diagnosed in practice?

ARPC is suspected with pruritic papules/nodules with central keratotic plugs. Diagnosis requires histopathological confirmation of transepidermal elimination of altered collagen fibers; dermoscopy and reflectance confocal microscopy can support assessment.

What treatments are reported for ARPC?

Reported treatments include antihistamines, keratolytics, topical/intralesional/oral corticosteroids, topical/systemic retinoids, phototherapy, dupilumab, and allopurinol, along with other therapies mentioned across the literature.

Sep 30, 2026

Uploaded by hdkawk