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Dermpath: Reactive Perforating Collagenosis

PostPosted: Mon Jan 18, 2016 1:53 pm
by CFH
Reactive perforating collagenosis is a skin disorder in which abnormal collagen fibers extrude through the epidermis. While the inherited form is a very rare condition, acquired reactive perforating collagenosis is more common and affects people with chronic renal failure, diabetes, hypothyroidism, hyperparathyroidism, liver disease, and lymphoma. The cause of abnormal collagen extruding through to the epidermis is unknown but lesions appear in response to superficial trauma such as scratching and are aggravated by cold weather. In acquired reactive perforating collagenosis keratotic lesions develop on the trunk and extremities and are commonly associated with pruritus.

: The low power view of perforating collagenosis shows cup shaped depression or invagination in the epidermis. There is prominent epidermal hyperplasia, which encompasses a central basophilic plug of keratin, collagen and inflammatory debris. Within the epidermal plug bright eosinophilic altered collagen fibers can be seen, as the process of transepidermal elimination is expelling the altered collagen from the underlying dermis.

- Wagner G, Sachse MM. Acquired reactive perforating dermatosis. J Dtsch Dermatol Ges. 2013 Aug;11(8):723-9, 723-30.
- Karpouzis A, Giatromanolaki A, Sivridis E, Kouskoukis C. Acquired reactive perforating collagenosis: Current status. J Dermatol. 2010 Jul;37(7):585-92.

Laurence Feldmeyer, MD, PhD, Department of Dermatology, Inselspital - Bern University Hospital, Bern, Switzerland