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CASE REPORT
Year : 2019  |  Volume : 37  |  Issue : 3  |  Page : 162-165

Successful treatment of acquired reactive perforating collagenosis induced by pregnancy with allopurinol: A case report with review of literature


1 Department of Dermatology, China Medical University Hospital; Department of Dermatology, School of Medicine, China Medical University, Taichung, Taiwan
2 Department of Dermatology, China Medical University Hospital, Taichung, Taiwan
3 Department of Pathology, Chang Bing Show Chwan Memorial Hospital, Lukang, Taiwan
4 Skin Institute, Hualien Tzu Chi Hospital, Institute of Medical Sciences, Tzu Chi University, Hualien, Taiwan
5 Department of Nursing, Central Taiwan University of Science and Technology, Taichung, Taiwan

Correspondence Address:
Dr. Chao-Jen Shih
Department of Nursing, Central Taiwan University of Science and Technology, Taichung
Taiwan
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/ds.ds_47_18

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Acquired reactive perforating collagenosis (ARPC) is a rare condition caused by transepidermal elimination of collagen, elastin fibers and keratin. To date, the pathogenesis of ARPC remains unknown. Different hypotheses were proposed, including superficial microtrauma due to pruritus and subsequent scratching, diabetes-induced microangiopathy, epidermal and dermal abnormalities in metabolic disorders, dermal microdeposits in patients with chronic renal failure and vasculopathy underlying chronic venous insufficiency and hypertension. In the past two decades, oral allopurinol had been found to be effective in treating ARPC. We report a case of a 36-year-old pregnant woman with itchy skin lesions on the trunk and four limbs since 36 weeks of her gestation. Initially, she was prescribed with oral antihistamine and topical steroid but did not respond well. Skin biopsy was performed and was compatible with ARPC. Normal renal and liver function tests were noted, and the HLA-B5801 test was negative. We treated the patient with allopurinol. Significant improvement was noticed at 1-month follow-up. To the best of our knowledge, this is the first case successfully treating ARPC induced by pregnancy with allopurinol. On careful follow-up of laboratory data and HLA-B5801 test screening, allopurinol may be another effective treatment option for ARPC patients after pregnancy.


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