Erworbene reaktiv perforierende Kollagenose bei Diabetes mellitus und dialysepflichtiger Niereninsuffizienz

Abstract

Acquired reactive perforating collagenosis should be considered when ulcera with oystershell-like keratotic plugs are found especially in patients with predisposing diseases like diabetes and renal insufficiency. A good interdisciplinary cooperation between internist and dermatologist is crucial for the early recognition by histopathology and the immediate treatment.

Colagenosis perforante reactiva adquirida

“…Las formas localizadas se tratan inicialmente con la aplicación de agentes queratolíticos como el ácido salicílico en concentración de 5 a 7%, urea de 10 a 15% y tretinoína de 0.01 a 0.1%; si es necesario, pueden aplicarse bajo oclusión. 2,7,23,25 En cuanto al tratamiento antiinflamatorio, se pueden emplear corticosteroides tópicos de clase II-III, aplicación intralesional de triamcinolona, al igual que retinoides tópicos. Para el tratamiento sistémico se pueden utilizar corticosteroides y retinoides, algunos autores recomiendan alopurinol; sin embargo, los resultados son contradictorios.…”

Acquired reactive perforating dermatosis

“…An important requirement for successful dermatological treatment of ARPD is the management of any associated internal or oncological disease (Table ). This includes the treatment of metabolic disorders, including optimal management of diabetes mellitus, effective dialysis, and if possible, curative treatment of existing solid or hematopoietic neoplasms .…”

“…Phototherapy presumably also has direct anti‐inflammatory and anti‐proliferative effects . Individual lesions are initially treated locally with keratolytic agents such as salicylic acid in a concentration of 5–7% in Vaseline, urea 10–15%, and tretinoin 0.01–0.1%; if necessary, the drugs may be applied under occlusion . After detachment of the crusts, and possibly curettage, treatment continues with class 2–3 corticosteroids; antiseptic agents may be given in addition .…”

“…After detachment of the crusts, and possibly curettage, treatment continues with class 2–3 corticosteroids; antiseptic agents may be given in addition . Intralesional injections of triamcinolone crystal suspension, or the application of topical retinoids, are further treatment options . For systemic treatment, corticosteroids and retinoids may be used .…”

“…Intralesional injections of triamcinolone crystal suspension, or the application of topical retinoids, are further treatment options . For systemic treatment, corticosteroids and retinoids may be used . The results for allopurinol are contradictory.…”