425 A superfacial ulcer on the scrotum

Abstract

A 54-year-old man presented to the dermatology clinic with an itchy red papule on the right scrotum for 2 years, which gradually expanded to a yellow central ulcerated plaque and the crust was not easy to be removed. Topical mupirocin and corticosteroids were not effective. Fluorescent microscopy for fungus was negative, as well as antibodies to syphilis and HIV. There was no similar history in his family, and he had hypertension for 14 years, type 2 diabetes for a year with normal renal function. Biopsy revealed epidermal necrosis and crust with transepidermal penetration and elimination of collagen. Therefore, the diagnosis was acquired reactive penetrating collagenosis (ARPC). Follow-up for 3 months after resection without recurrence. Reactive perforating collagenosis is a rare skin disease that includes both inherited and acquired forms. ARPC is associated with diabetes, chronic renal failure, hyperuricemia and hypertension. It usually occurs on the trunk and limbs, characterized by multiple umbilicated hyperkeratotic papules or nodules with Koebner's phenomenon clinically, but no scrotal lesions have been reported.