Acquired Reactive Perforating Collagenosis: A Cinicopathological Studywith Evaluation of Narrowban

Abstract

Background/Objectives: Acquired reactive perforating collagenosis (ARPC) is an uncommon dermatologic disorder which usually associated with systemic diseases mostly diabetes mellitus and renal diseases. We aim to: determine the clinicopathological characteristics of ARPC in Egyptian patients together with testing responsiveness to narrow band UVB alone or with combination with other drugs.

Methods: clinical data were obtained; (history, examination, routine laboratory work up and skin biopsy). Different staining techniques were applied.

Results: Two clinicopathological forms were recognized. A common form which includes 9 patients and it was characterized by a slowly progressive course and it was usually associated with underlying systemic diseases. The second form (2 patients) was characterized by an acute onset, rapid progressive course and it was characterized by malignancy association. This form was more characterized by prominent epidermal necrosis, increased vascular reaction, increased bacterial colonies and neutrophilic infiltrate in the keratotic plug. Patients who treated by NBUVB alone (4 patients) showed mild to moderate improvement, while combination of NBUVB with other systemic therapy such as doxycycline, azithromycin, acitretin and allopurinol showed moderate to excellent response.

Conclusion: ARPC may be presented with more than one form which showed different clinical and pathological features. The role of NBUVB may be limited as a monotherapy but satisfied results can be obtained when combined with other therapeutic modalities especially antibiotics.

Abstract

Background/Objectives: Acquired reactive perforating collagenosis (ARPC) is an uncommon dermatologic disorder which usually associated with systemic diseases mostly diabetes mellitus and renal diseases. We aim to: determine the clinicopathological characteristics of ARPC in Egyptian patients together with testing responsiveness to narrow band UVB alone or with combination with other drugs.

Methods: clinical data were obtained; (history, examination, routine laboratory work up and skin biopsy). Different staining techniques were applied.

Results: Two clinicopathological forms were recognized. A common form which includes 9 patients and it was characterized by a slowly progressive course and it was usually associated with underlying systemic diseases. The second form (2 patients) was characterized by an acute onset, rapid progressive course and it was characterized by malignancy association. This form was more characterized by prominent epidermal necrosis, increased vascular reaction, increased bacterial colonies and neutrophilic infiltrate in the keratotic plug. Patients who treated by NBUVB alone (4 patients) showed mild to moderate improvement, while combination of NBUVB with other systemic therapy such as doxycycline, azithromycin, acitretin and allopurinol showed moderate to excellent response.

Conclusion: ARPC may be presented with more than one form which showed different clinical and pathological features. The role of NBUVB may be limited as a monotherapy but satisfied results can be obtained when combined with other therapeutic modalities especially antibiotics.