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Li J, Zhou C. Recalcitrant Reactive Perforating Collagenosis Successfully Treated with Dupilumab: A Case Report. Clin Cosmet Investig Dermatol 2024; 17:1329-1332. [PMID: 38864026 PMCID: PMC11166152 DOI: 10.2147/ccid.s465766] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/03/2024] [Accepted: 05/28/2024] [Indexed: 06/13/2024]
Abstract
Reactive perforating collagenosis (RPC) is the most common form of the perforating dermatoses, which include RPC, elastosis perforans serpiginosa (EPS), perforating folliculitis (PF), and Kyrle disease (KD). In RPC, altered collagen of the dermis is extruded through the epidermis, which can be misdiagnosed as other skin diseases, such as vasculitis or prurigo nodularis. RPC is associated with a number of conditions, including diabetes mellitus, hepatitis, and renal failure, and thus the management of the coexisting diseases is important. There is currently no standardized and effective treatment method for RPC. Here, we report a patient with RPC who was resistant to topical corticosteroids, oral loratadine, and thalidomide, and responded well to dupilumab without significant side effects.
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Affiliation(s)
- Jiecheng Li
- Department of Dermatology, Peking University People’s Hospital, Beijing, People’s Republic of China
| | - Cheng Zhou
- Department of Dermatology, Peking University People’s Hospital, Beijing, People’s Republic of China
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2
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Ding W, Wang Y, Song L, Zhou N. A potential new treatment with upadacitinib for acquired reactive perforating collagenosis. JAAD Case Rep 2024; 48:112-114. [PMID: 38813063 PMCID: PMC11134568 DOI: 10.1016/j.jdcr.2024.04.017] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/31/2024] Open
Affiliation(s)
- Wei Ding
- Department of Dermatology, the First Affiliated Hospital of Soochow University, Suzhou, Jiangsu Province, China
| | - Yuting Wang
- Department of Dermatology, the First Affiliated Hospital of Soochow University, Suzhou, Jiangsu Province, China
| | - Linyi Song
- Department of Dermatology, the First Affiliated Hospital of Soochow University, Suzhou, Jiangsu Province, China
| | - Naihui Zhou
- Department of Dermatology, the First Affiliated Hospital of Soochow University, Suzhou, Jiangsu Province, China
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Hasegawa Y, Takahashi Y, Nagasawa K, Kinno H, Oda T, Hangai M, Odashima Y, Suzuki Y, Shimizu J, Ando T, Egawa I, Hashizume K, Nata K, Yabe D, Horikawa Y, Ishigaki Y. Japanese 17q12 Deletion Syndrome with Complex Clinical Manifestations. Intern Med 2024; 63:687-692. [PMID: 38432894 PMCID: PMC10982014 DOI: 10.2169/internalmedicine.1660-23] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/21/2023] [Accepted: 05/29/2023] [Indexed: 03/05/2024] Open
Abstract
17q12 deletion syndrome is a rare chromosomal anomaly with variable phenotypes, caused by the heterozygous deletion of chromosome 17q12. We herein report a 35-year-old Japanese patient with chromosomal 17q12 deletion syndrome identified by de novo deletion of the 1.46 Mb segment at the 17q12 band by genetic analyses. He exhibited a wide range of phenotypes, such as maturity-onset diabetes of the young (MODY) type 5, structural or functional abnormalities of the kidney, liver, and pancreas; facial dysmorphic features, electrolyte disorders; keratoconus, and acquired perforating dermatosis. This case report provides valuable resources concerning the clinical spectrum of rare 17q12 deletion syndrome.
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Affiliation(s)
- Yutaka Hasegawa
- Division of Diabetes, Metabolism and Endocrinology, Department of Internal Medicine, Iwate Medical University, Japan
| | - Yoshihiko Takahashi
- Division of Diabetes, Metabolism and Endocrinology, Department of Internal Medicine, Iwate Medical University, Japan
| | - Kan Nagasawa
- Division of Diabetes, Metabolism and Endocrinology, Department of Internal Medicine, Iwate Medical University, Japan
| | - Hirofumi Kinno
- Division of Diabetes, Metabolism and Endocrinology, Department of Internal Medicine, Iwate Medical University, Japan
| | - Tomoyasu Oda
- Division of Diabetes, Metabolism and Endocrinology, Department of Internal Medicine, Iwate Medical University, Japan
| | - Mari Hangai
- Division of Diabetes, Metabolism and Endocrinology, Department of Internal Medicine, Iwate Medical University, Japan
| | - Yoshimi Odashima
- Division of Diabetes, Metabolism and Endocrinology, Department of Internal Medicine, Iwate Medical University, Japan
| | - Yoko Suzuki
- Division of Diabetes, Metabolism and Endocrinology, Department of Internal Medicine, Iwate Medical University, Japan
| | - Jun Shimizu
- Division of Diabetes, Metabolism and Endocrinology, Department of Internal Medicine, Iwate Medical University, Japan
| | - Toshihiko Ando
- Division of Diabetes, Metabolism and Endocrinology, Department of Internal Medicine, Iwate Medical University, Japan
| | - Isao Egawa
- Department of Ophthalmology, School of Medicine, Iwate Medical University, Japan
| | - Kouhei Hashizume
- Department of Ophthalmology, School of Medicine, Iwate Medical University, Japan
| | - Koji Nata
- Division of Medical Biochemistry, School of Pharmacy, Iwate Medical University, Japan
| | - Daisuke Yabe
- Department of Diabetes, Endocrinology and Metabolism/Department of Rheumatology and Clinical Immunology, Gifu University Graduate School of Medicine, Japan
| | - Yukio Horikawa
- Department of Diabetes, Endocrinology and Metabolism/Department of Rheumatology and Clinical Immunology, Gifu University Graduate School of Medicine, Japan
- Clinical Genetics Center, Gifu University Hospital, Japan
| | - Yasushi Ishigaki
- Division of Diabetes, Metabolism and Endocrinology, Department of Internal Medicine, Iwate Medical University, Japan
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Huang F, Ren W, Wang M, Li X, Pan M. Acquired reactive perforating collagenosis combined with MRSA: A case report. MEDICINE INTERNATIONAL 2023; 3:9. [PMID: 36793622 PMCID: PMC9922796 DOI: 10.3892/mi.2023.69] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/20/2022] [Accepted: 01/23/2023] [Indexed: 01/27/2023]
Abstract
Acquired reactive perforating collagenosis (ARPC) is a rare chronic skin disease associated with various internal diseases, particularly diabetes and chronic renal failure. The present study describes the case of a patient with ARPC combined with methicillin-resistant Staphylococcus aureus (MRSA), in an aim to broaden the current understanding of ARPC. A 75-year-old female presented with a 5-year history of pruritus and ulcerative eruptions on the trunk of her body, which became more severe within 1 year. A cutaneous examination revealed a diffuse distribution of erythema and papules, and nodules of various sizes, some of which sagged at the center and had a dark brown crust. A histopathological analysis revealed typical perforations of the collagen fibers. The patient was initially treated with topical corticosteroids and oral antihistamines for skin lesions and pruritus. Medications for glucose control were also administered. Upon the second admission, a combination of antibiotics and acitretin was added. The keratin plug shrank, and the pruritus was relieved. To date, to the best of our knowledge, this is the first reported case of concurrent ARPC and MRSA.
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Affiliation(s)
- Fuqian Huang
- Department of Dermatology, Affiliated Hospital of Qingdao University, Qingdao, Shandong 266003, P.R. China
| | - Weiqi Ren
- Department of Dermatology, Affiliated Hospital of Qingdao University, Qingdao, Shandong 266003, P.R. China
| | - Miaomiao Wang
- Department of Dermatology, Affiliated Hospital of Qingdao University, Qingdao, Shandong 266003, P.R. China
| | - Xiufang Li
- Department of Dermatology, Affiliated Hospital of Qingdao University, Qingdao, Shandong 266003, P.R. China
| | - Min Pan
- Department of Dermatology, Affiliated Hospital of Qingdao University, Qingdao, Shandong 266003, P.R. China
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Dupilumab in acquired perforating dermatosis: A potential new treatment. JAAD Case Rep 2022; 28:34-36. [PMID: 36097624 PMCID: PMC9463549 DOI: 10.1016/j.jdcr.2022.08.013] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
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Gil‐Lianes J, Riquelme‐Mc Loughlin C, Mascaró JM. Reactive perforating collagenosis successfully treated with dupilumab. Australas J Dermatol 2022; 63:398-400. [PMID: 35633371 PMCID: PMC9544964 DOI: 10.1111/ajd.13874] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2022] [Revised: 05/01/2022] [Accepted: 05/09/2022] [Indexed: 11/03/2022]
Affiliation(s)
- Javier Gil‐Lianes
- Dermatology DepartmentHospital Clínic de BarcelonaUniversitat de BarcelonaBarcelonaSpain
| | | | - Jose Manuel Mascaró
- Dermatology DepartmentHospital Clínic de BarcelonaUniversitat de BarcelonaBarcelonaSpain
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Ying Y, Shuang C, Zhen‐Ying Z. Dupilumab may be an alternative option in the treatment of acquired reactive perforating collagenosis combined with AD. Immun Inflamm Dis 2022; 10:e574. [PMID: 34953055 PMCID: PMC8926492 DOI: 10.1002/iid3.574] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/14/2021] [Revised: 11/02/2021] [Accepted: 11/13/2021] [Indexed: 11/18/2022] Open
Abstract
The management of acquired reactive perforating collagenosis (ARPC) is challenging. Here, we shared two cases of ARPC combined with elderly atopic dermatitis (AD) that did not respond well to conventional treatment but responded well to the monotherapy of dupilumab, which suggests that dupilumab may be an alternative option for the treatment.
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Affiliation(s)
- Yang Ying
- Department of DermatologyThe University of Hong Kong‐Shenzhen HospitalShenzhenGuangdongChina
| | - Chen Shuang
- Department of PathologyThe University of Hong Kong‐Shenzhen HospitalShenzhenGuangdongChina
| | - Zhang Zhen‐Ying
- Department of DermatologyThe University of Hong Kong‐Shenzhen HospitalShenzhenGuangdongChina
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Bellinato F, Maurelli M, Gisondi P, Girolomoni G. Acquired perforating dermatoses show increased levels of cutaneous advanced glycation end-products. Clin Exp Dermatol 2021; 47:80-85. [PMID: 34260091 DOI: 10.1111/ced.14851] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/09/2021] [Indexed: 01/14/2023]
Abstract
BACKGROUND Acquired perforating dermatoses (APDs) are characterized by transepidermal elimination of skin materials. Altered glycation of dermal components may be involved in pathogenesis. AIM To assess whether patients affected by APDs have increased levels of cutaneous advanced glycation end-products (AGEs). METHODS A cross-sectional controlled study involving a total of 109 patients was conducted, enrolling 29 patients consecutively diagnosed with primary APDs [reactive perforating collagenosis (RPC), elastosis perforans serpiginosa (EPS), perforating folliculitis (PF) and Kyrle disease (KD)], 40 age- and sex-matched healthy controls (HCs) and 40 patients with mild atopic dermatitis (AD). The levels of cutaneous AGEs were measured using a validated fluorescence technique. RESULTS The median skin autofluorescence value in patients with APDs was significantly higher [2.7 arbitrary units (AU), interquartile range (IQR) 1.9-3.9 AU] compared with HCs (1.8 AU, IQR 1.6-2.3 AU; P < 0.001) and patients with AD (2.1 AU, IQR 1.9-2.3 AU; P = 0.01). Median values were 3.5 AU (IQR 2.7-4.6 AU) for RPC, 1.83.5 AU (1.4-2.4 AU) for EPS, 3.1 AU (2.4-4.4 AU) for PF and 2.6 AU (2.3-3.1 AU) for KD. CONCLUSIONS Our results may suggest a possible physiopathological role of AGEs in the transepidermal elimination mechanisms involved in certain APDs.
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Affiliation(s)
- F Bellinato
- Section of Dermatology and Venereology, Department of Medicine, University of Verona, Verona, Italy
| | - M Maurelli
- Section of Dermatology and Venereology, Department of Medicine, University of Verona, Verona, Italy
| | - P Gisondi
- Section of Dermatology and Venereology, Department of Medicine, University of Verona, Verona, Italy
| | - G Girolomoni
- Section of Dermatology and Venereology, Department of Medicine, University of Verona, Verona, Italy
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Gil F, Cardoso JC, Gil J. Successful Treatment of Acquired Perforating Dermatosis with Colchicine. Indian Dermatol Online J 2021; 12:355-356. [PMID: 33959546 PMCID: PMC8088170 DOI: 10.4103/idoj.idoj_504_20] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/04/2020] [Revised: 07/18/2020] [Accepted: 09/05/2020] [Indexed: 11/22/2022] Open
Affiliation(s)
- Francisco Gil
- Dermatology Department, Hospital de Santarém EPE, Santarém, Portugal
| | - José Carlos Cardoso
- Dermatology Department, Coimbra - "Centro Hospitalar e Universitário de Coimbra" Centro Hospitalar e Universitário de Coimbra, Portugal.,Centro de Diagnóstico Anátomo-Patológico, Coimbra, Portugal
| | - José Gil
- Dermatology Department, Unidade Local de Saúde de Castelo Branco, Castelo Branco, Portugal
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Gontijo JRV, Júnior FF, Pereira LB, Pedrosa MS. Trauma-induced acquired reactive perforating collagenosis. An Bras Dermatol 2021; 96:392-393. [PMID: 33840572 PMCID: PMC8178551 DOI: 10.1016/j.abd.2020.06.022] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2020] [Revised: 06/23/2020] [Accepted: 06/24/2020] [Indexed: 11/27/2022] Open
Affiliation(s)
- João Renato Vianna Gontijo
- Dermatology Service, Hospital das Clínicas, Universidade Federal de Minas Gerais, Belo Horizonte, MG, Brazil; Dermatology Service, Hospital Mater Dei, Belo Horizonte, MG, Brazil.
| | | | - Luciana Baptista Pereira
- Dermatology Service, Hospital das Clínicas, Universidade Federal de Minas Gerais, Belo Horizonte, MG, Brazil; Faculty of Medicine, Universidade Federal de Minas, Belo Horizonte, MG, Brazil
| | - Moisés Salgado Pedrosa
- Patology Service, Hospital das Clínicas, Universidade Federal de Minas Gerais, Belo Horizonte, MG, Brazil
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Hasbún C, Sandoval M, González-Bombardiere S. Case for diagnosis. Hyperpigmented and excoriated papules and nodules in a diabetic patient. An Bras Dermatol 2020; 95:757-759. [PMID: 33036808 PMCID: PMC7672397 DOI: 10.1016/j.abd.2020.03.015] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/10/2019] [Accepted: 03/04/2020] [Indexed: 11/29/2022] Open
Abstract
Reactive perforating collagenosis is a rare perforating dermatosis clinically characterized by intensely pruritic hyperpigmented papules, plaques, and nodules with a central keratotic plug. Histopathology reveals transepidermal elimination of collagen fibers. Its pathophysiology is still under investigation, but the acquired form has been linked to systemic conditions such as diabetes mellitus and chronic kidney disease. However, it has also been described as a paraneoplastic syndrome. The authors present the case of a 65-year-old diabetic patient in which a myeloproliferative neoplasm was suspected.
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Affiliation(s)
- Catalina Hasbún
- School of Medicine, Faculty of Medicine, Pontificia Universidad Católica de Chile, Santiago, Chile
| | - Mauricio Sandoval
- Department of Dermatology, Faculty of Medicine, Pontificia Universidad Católica de Chile, Santiago, Chile.
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Wang MF, Mei XL, Wang L, Lin-Feng L. Clinical characteristics and prognosis of acquired perforating dermatosis: A case report. Exp Ther Med 2020; 19:3634-3640. [PMID: 32346428 PMCID: PMC7185186 DOI: 10.3892/etm.2020.8651] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/14/2019] [Accepted: 11/05/2019] [Indexed: 11/06/2022] Open
Abstract
Acquired perforating dermatosis (APD) is an uncommon skin disease characterized by umbilicated hyperkeratotic lesions, and involves the transepidermal elimination of dermal components, including collagen and elastic fibers. The disease can affect patients with systemic disorders, especially those with chronic renal failure or diabetes mellitus. The current paper described four cases of patients with APD and investigated the clinical characteristics and prognosis of APD, as well as its possible link with systemic disorders. In each of the four cases, the patient had systemic disorders before the onset of APD, three had concomitant renal and thyroid disorders and one had hepatocirrhosis secondary to chronic hepatitis C. The results of the present study showed that APD occurred after the transient worsening of the original systemic disease. Furthermore, it was revealed that dermatosis symptoms were alleviated upon remission of the original systemic disorder, without specific dermatological treatment. Dermatosis symptoms improved in all four patients, indicating that the management of the associated systematic diseases was essential for the successful clinical outcomes of APD.
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Affiliation(s)
- Mei-Fang Wang
- Department of Dermatology, Beijing Friendship Hospital, Capital Medical University, Beijing 100050, P.R. China
| | - Xue-Ling Mei
- Department of Dermatology, Beijing Friendship Hospital, Capital Medical University, Beijing 100050, P.R. China
| | - Li Wang
- Department of Dermatology, Beijing Friendship Hospital, Capital Medical University, Beijing 100050, P.R. China
| | - Li Lin-Feng
- Department of Dermatology, Beijing Friendship Hospital, Capital Medical University, Beijing 100050, P.R. China
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Huseynova L, Akdogan N, Gököz Ö, Evans SE. Acquired reactive perforating collagenosis in association with prostate adenocarcinoma, chronic lymphocytic leukemia, and Graves' disease. An Bras Dermatol 2020; 95:336-339. [PMID: 32359703 PMCID: PMC7253912 DOI: 10.1016/j.abd.2019.09.029] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/20/2019] [Accepted: 09/03/2019] [Indexed: 11/14/2022] Open
Abstract
Acquired reactive perforating collagenosis is a rare skin disorder characterized by the presence of umbilicated pruritic papules and nodules. Transepidermal elimination of altered and perforating bundles of basophilic collagen from the epidermis is a characteristic histologic feature of acquired reactive perforating collagenosis. Along with its well-known association with systemic diseases such as diabetes mellitus, chronic renal failure, and dermatomyositis, there are reports of acquired reactive perforating collagenosis being associated with malignancies. Herein, we present a case of acquired reactive perforating collagenosis associated with chronic lymphocytic leukemia, prostate adenocarcinoma, and Graves's disease. Clinicians are required to be more vigilant in evaluating patients with acquired reactive perforating collagenosis due to its unique association with malignancies and other systemic diseases.
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Affiliation(s)
- Leyla Huseynova
- Department of Dermatology and Venerology, Faculty of Medicine, Hacettepe University, Ankara, Turkey
| | - Neslihan Akdogan
- Department of Dermatology and Venerology, Faculty of Medicine, Hacettepe University, Ankara, Turkey.
| | - Özay Gököz
- Department of Pathology, Faculty of Medicine, Hacettepe University, Ankara, Turkey
| | - Sibel Ersoy Evans
- Department of Dermatology and Venerology, Faculty of Medicine, Hacettepe University, Ankara, Turkey
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Abstract
Diabetes mellitus is a widespread endocrine disease with severe impact on health systems worldwide. Increased serum glucose causes damage to a wide range of cell types, including endothelial cells, neurons, and renal cells, but also keratinocytes and fibroblasts. Skin disorders can be found in about one third of all people with diabetes and frequently occur before the diagnosis, thus playing an important role in the initial recognition of underlying disease. Noninfectious as well as infectious diseases have been described as dermatologic manifestations of diabetes mellitus. Moreover, diabetic neuropathy and angiopathy may also affect the skin. Pruritus, necrobiosis lipoidica, scleredema adultorum of Buschke, and granuloma annulare are examples of frequent noninfectious skin diseases. Bacterial and fungal skin infections are more frequent in people with diabetes. Diabetic neuropathy and angiopathy are responsible for diabetic foot syndrome and diabetic dermopathy. Furthermore, antidiabetic therapies may provoke dermatologic adverse events. Treatment with insulin may evoke local reactions like lipohypertrophy, lipoatrophy and both instant and delayed type allergy. Erythema multiforme, leukocytoclastic vasculitis, drug eruptions, and photosensitivity have been described as adverse reactions to oral antidiabetics. The identification of lesions may be crucial for the first diagnosis and for proper therapy of diabetes.
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Kittisak P, Tanaka M. Dermoscopic findings in a case of reactive perforating collagenosis. Dermatol Pract Concept 2015; 5:75-7. [PMID: 26114057 PMCID: PMC4462904 DOI: 10.5826/dpc.0502a13] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2014] [Accepted: 02/04/2015] [Indexed: 10/31/2022] Open
Affiliation(s)
- Payapvipapong Kittisak
- Division of Dermatology, Department of Medicine, Phramongkutklao Hospital, Bangkok, Thailand
| | - Masaru Tanaka
- Department of Dermatology, Tokyo Women's Medical University Medical Center East, Tokyo, Japan
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