Treatment of acquired reactive perforating collagenosis with allopurinol incidentally improves scleredema diabeticorum

Abstract

To the Editor: Acquired reactive perforating collagenosis is a condition characterized by altered collagen eliminated through the epidermis. It is usually associated with diabetes mellitus and chronic renal disease. Oral allopurinol has been described to be effective in treating acquired reactive perforating collagenosis. 1 Querings K. Balda B.R. Bachter D. Treatment of acquired reactive perforating collagenosis with allopurinol. Br J Dermatol. 2001; 145: 174-176 Crossref PubMed Scopus (33) Google Scholar Scleredema diabeticorum (SD) is also a dermatological complication of diabetes mellitus. It is characterized by diffuse swelling and nonpitting induration of the skin, especially on the upper trunk and neck. The histologic findings include a thickened broad dermis with mucin between thickened collagen bundles. SD is difficult to treat. Many therapies, including ultraviolet (UV) A1 phototherapy, bath psoralen UVA, narrowband UVB, extracorporeal photopheresis, radiation, electron beam, cyclosporine, methotrexate and high-dose penicillin, have been reported to be effective in separate cases. We report a case of acquired reactive perforating collagenosis treated with allopurinol treatment. Surprisingly, the concomitant SD improved simultaneously. This case implied the therapeutic effect of allopurinol in SD.