Successful Treatment with Allopurinol and Strict Glycemic Control for Acquired Reactive Perforating Collagenosis in a Patient with Type 1 Diabetes and Chronic Renal Failure

DOI Web Site 25 References
  • Bouchi Ryotaro
    Diabetes Center, Tokyo Women's Medical University School of Medicine
  • Teno Shinichi
    Diabetes Center, Tokyo Women's Medical University School of Medicine
  • Tsukahara Sachie
    Diabetes Center, Tokyo Women's Medical University School of Medicine
  • Tanaka Nobue
    Diabetes Center, Tokyo Women's Medical University School of Medicine
  • Kanno Hiroko
    Diabetes Center, Tokyo Women's Medical University School of Medicine
  • Ishii Akiko
    Diabetes Center, Tokyo Women's Medical University School of Medicine
  • Nakagami Tomoko
    Diabetes Center, Tokyo Women's Medical University School of Medicine
  • Kawashima Makoto
    Department of Dermatology, Tokyo Women's Medical University School of Medicine
  • Iwamoto Yasuhiko
    Diabetes Center, Tokyo Women's Medical University School of Medicine

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Other Title
  • 後天性反応性穿孔性皮膚症に厳格な血糖コントロールとアロプリノールが奏効した1型糖尿病慢性腎不全の1例
  • 症例報告 後天性反応性穿孔性皮膚症に厳格な血糖コントロールとアロプリノールが奏効した1型糖尿病慢性腎不全の1例
  • ショウレイ ホウコク コウテンセイ ハンノウセイ センコウセイ ヒフショウ ニ ゲンカク ナ ケットウ コントロール ト アロプリノール ガ ソウコウ シタ 1ガタ トウニョウビョウ マンセイ ジンフゼン ノ 1レイ

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Acquired reactive perforating collagenosis (ARPC) is a rare skin disease characterized by transepidermal elimination of altered collagen, and is often complicated with diabetes mellitus and chronic renal failure. We report a case of ARPC in a 26-year-old Japanese woman with type 1 diabetes mellitus with end-stage renal disease undergoing hemodialysis. Although she had been treated with insulin after diabetes was diagnosed when she was 9 years old, her diabetic control remained poor. In 2001, when she was 23 years old, she suffered from itchy papules, nodules, and erosions on the extensor surface of the legs and back, clinically diagnosed as ARPC in 2001. Although she had taken local treatment including corticosteroid and anti-histamic medicine for 4 years, these treatments were not fully effective. After she started hemodialysis in May, 2002, she was admitted for clinical assessment for renal transplantation in March 2004. After admission, she took a 1800 kcal, protein uptake 40 g of medical nutrition therapy and intensive insulin injection for glycemic control and 100 mg of allopurinol administration once a day for ARPC. Two weeks after allopurinol administration, her itching disappeared and her itchy papules, nodules, and erosions responded well 8 weeks after allopurinol administration. ARPC pathology is not fully understood and treatment remains difficult. Our report implies that allopurinol and aggressive control of blood glucose are effective against ARPC.

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