Acquired reactive perforating collagenosis in association with hepatorenal failure: a case report and literature review

Reactive perforating collagenosis is a rare perforating dermatosis characterized by transepidermal elimination of collagen.We report a 63-year-old male with diabetes, hypertension, chronic kidney disease, and cirrhosis from hepatitis B, presenting with keratotic, pruritic papules on the back.Histopathological examination showed a crater filled with a keratin plug and transepidermal elimination of collagen, confirming the diagnosis of acquired perforating dermatosis (APD).APD is associated with systemic diseases, mainly diabetes, and diagnosis depends on the clinicopathological correlation of the lesions.This case highlights the importance of early diagnosis to improve the patient's quality of life and demonstrates an atypical distribution/ site of involvement.