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      Therapeutics and Clinical Risk Management (submit here)

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      Doxycycline Combined with NB-UVB Phototherapy for Acquired Reactive Perforating Collagenosis


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          Acquired reactive perforating collagenosis is a rare skin disease characterized by the discharge of collagen fibers through the epidermis. There is no standard treatment for this disease currently. Here, we report a case of ARPC that has been successfully treated and cured.

          Case Description

          A 32-year-old man developed severe itching papules on his torso and limbs for 3 months. Skin lesions were keratotic papules scattered on the limbs and trunk, with a diameter of 3 to 12 mm. Some lesions had umbilical recesses and the shape of a crater with positive isomorphic reactions. The patient scratched his severe itching lesions which merged into large ones. This patient had histories of hypertension and dilated cardiomyopathy with mild congestive heart failure. The clinical presentation and histopathology of skin lesions met Faver’s diagnostic criteria for ARPC.


          Oral Doxycycline 100mg/d, NB-UVB phototherapy 3 times a week with initial dose 400mJ/cm 2, gradually increased to 1200mJ/cm 2(total cumulative dose 16700J/cm 2).


          After a week of treatment, the patient’s itching symptoms were significantly reduced and stopped presenting any new skin lesions. Most of the lesions healed in 6 weeks of treatment.


          Doxycycline combined with NB-UVB may be an effective treatment for ARPC.

          Most cited references13

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          A Clinicopathologic Study of Thirty Cases of Acquired Perforating Dermatosis in Korea

          Background Acquired perforating dermatosis (APD) is histopathologically characterized by transepidermal elimination of materials from the upper dermis. APD can be divided into four diseases: Kyrle's disease, perforating folliculitis, elastosis perforans serpiginosa, and reactive perforating collagenosis. APD is usually associated with systemic diseases, especially diabetes mellitus or chronic renal failure. So far, there have only been a few Korean studies of APD, which have a limited number of patients. Objective The aim of this study is to evaluate the clinical and histopathologic characteristics of 30 cases of APD and to examine the association with systemic diseases. Methods We retrospectively reviewed the medical records and biopsy specimens of 30 patients who were diagnosed with APD. Results The mean age was 55.5 years, and the average duration of the lesion was 7.8 months. The lower extremities (73.3%) were the most frequently occurring sites of the lesion. Twenty-five patients (83.3%) had pruritus, and Koebner's phenomenon was present in 11 patients. Patients of 63.3% had at least one systemic disease. Diabetes mellitus (n=17, 56.7%) and chronic renal failure (n=10, 33.3%) were the most commonly associated conditions. Most patients received topical steroids (93.3%) and antihistamines (80.0%). The most common histopathologic type was reactive perforating collagenosis (n=23, 73.3%). Conclusion In this study, most patients had a systemic association to the diseases. Therefore, we suggest that further evaluation is necessary for patients who present with APD. This includes reviewing patient's comprehensive past medical history, clinical exam, and additional diagnostic testing to check for the possibility of associated systemic diseases.
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            Acquired reactive perforating collagenosis: current status.

            Acquired reactive perforating collagenosis is a unique perforating dermatosis, characterized clinically by umbilicated hyperkeratotic papules or nodules and histologically by a focal hyperkeratosis in direct contact with transepidermal perforating dermal collagen. Several inflammatory or malignant systemic diseases may coexist with acquired reactive perforating collagenosis. The possible biochemical or immunological mechanisms of the systemic diseases, potentially responsible for the development and appearance of acquired reactive perforating collagenosis, are still under investigation. Several topical treatments, ultraviolet B phototherapy and allopurinol p.o. administration may be effective.
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              Acquired perforating dermatosis: clinicopathological study of 31 cases, emphasizing pathogenesis and treatment.

              Acquired perforating dermatosis (APD) is a rare group of skin disorders of unknown aetiology and pathogenesis and is associated with several systemic diseases.

                Author and article information

                Ther Clin Risk Manag
                Therapeutics and Clinical Risk Management
                24 September 2020
                : 16
                : 917-921
                [1 ]Department of Dermatology, Affiliated Hospital of Nantong University , Nantong, Jiangsu Province, People’s Republic of China
                Author notes
                Correspondence: Shuanglin Cao Department of Dermatology, Affiliated Hospital of Nantong University , 20th Xisi Road, Nantong, People’s Republic of China Email slcao@medmail.com.cn
                © 2020 Gao et al.

                This work is published and licensed by Dove Medical Press Limited. The full terms of this license are available at https://www.dovepress.com/terms.php and incorporate the Creative Commons Attribution – Non Commercial (unported, v3.0) License ( http://creativecommons.org/licenses/by-nc/3.0/). By accessing the work you hereby accept the Terms. Non-commercial uses of the work are permitted without any further permission from Dove Medical Press Limited, provided the work is properly attributed. For permission for commercial use of this work, please see paragraphs 4.2 and 5 of our Terms ( https://www.dovepress.com/terms.php).

                : 10 July 2020
                : 21 August 2020
                Page count
                Figures: 4, References: 13, Pages: 5
                Case Report

                acquired reactive perforating collagenosis,doxycycline,nb-uvb,hypertension
                acquired reactive perforating collagenosis, doxycycline, nb-uvb, hypertension


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