Systematic review and meta-analysis Literature-based Clinical Retrospective Analysis of Acquired Reactive Perforating Collagenosis

Abstract

Objective: Acquired reactive perforating collagenosis(ARPC) is a rare dermatosis that usually associated with systemic disease. The associations, characteristics and treatment rigemen of ARPC are not well understood.This study was performed to retrospectively evaluate the diagnosis and treatment statuses of acquired reactive perforating collagenosis (ARPC). Methods: A systematic review of the PubMed, Embase, and Scopus databases was independently performed by two reviewers. Data were extracted and qualitatively analyzed. The quality of the articles was assessed by using the Newcastle–Ottawa scale. The data are described in the manuscript. The study was registered with PROSPERO, CRD 42023448576. Results: In total, 189 patients (98 women, 91 men) in 124 studies were analyzed. Their mean age was 57.31 ± 15.21 years. A total of 88.89% (n = 168) of the patients had one or more systemic diseases, of which 57.67% (n = 109) had diabetes mellitus, 29.10% (n = 55) had chronic renal failure, 25.93% (n = 49) had hypertension, and 13.76% had malignancy (n = 26). The most frequently affected area was the lower extremities (72.49%, n = 137), followed by the trunk (70.37%, n = 133) and the upper extremities (63.49%, n = 120). One hundred sixty (84.66%) patients had pruritus, and 32.80% (n = 62) of them were positive for the Koebner phenomenon. Oral antihistamines and topical steroids were the most common treatments in this study, followed by narrow-band ultraviolet B therapy and allopurinol. Management of concomitant systemic diseases also resulted in improvement of ARPC. Conclusion: In this review, ARPC was frequently associated with systemic diseases, especially diabetes mellitus, renal failure, hypertension, and malignancy. The lower extremities and trunk were the most frequently affected areas, and pruritus usually appeared. Antihistamines and topical steroids were the most commonly used treatments, and we recommend narrow-band ultraviolet B therapy as the first-line treatment. Management of systemic diseases and relief of pruritus should be considered simultaneously.