Medscape is available in 5 Language Editions – Choose your Edition here.


Reactive Perforating Collagenosis Differential Diagnoses

  • Author: Susan Cooper, MB, ChB, MD, FRCP; Chief Editor: Dirk M Elston, MD  more...
Updated: Aug 18, 2015
Contributor Information and Disclosures

Susan Cooper, MB, ChB, MD, FRCP MRCGP, FRCP, Consultant Dermatologist and Honorary Senior Clinical Lecturer, Department of Dermatology, Churchill Hospital, UK

Susan Cooper, MB, ChB, MD, FRCP is a member of the following medical societies: Royal College of Physicians

Disclosure: Nothing to disclose.


Ruth G Asher, MBChB FRCPath, Locum Consultant Dermatopathologist, John Radcliffe Hospital, Oxford

Ruth G Asher, MBChB is a member of the following medical societies: International Academy of Pathology, Royal Society of Medicine, International Society of Dermatopathology, British Society for Dermatopathology, Association of Clinical Pathologists

Disclosure: Nothing to disclose.

Specialty Editor Board

Richard P Vinson, MD Assistant Clinical Professor, Department of Dermatology, Texas Tech University Health Sciences Center, Paul L Foster School of Medicine; Consulting Staff, Mountain View Dermatology, PA

Richard P Vinson, MD is a member of the following medical societies: American Academy of Dermatology, Texas Medical Association, Association of Military Dermatologists, Texas Dermatological Society

Disclosure: Nothing to disclose.

Rosalie Elenitsas, MD Herman Beerman Professor of Dermatology, University of Pennsylvania School of Medicine; Director, Penn Cutaneous Pathology Services, Department of Dermatology, University of Pennsylvania Health System

Rosalie Elenitsas, MD is a member of the following medical societies: American Academy of Dermatology, American Medical Association, American Society of Dermatopathology, Pennsylvania Academy of Dermatology

Disclosure: Received royalty from Lippincott Williams Wilkins for textbook editor.

Chief Editor

Dirk M Elston, MD Professor and Chairman, Department of Dermatology and Dermatologic Surgery, Medical University of South Carolina College of Medicine

Dirk M Elston, MD is a member of the following medical societies: American Academy of Dermatology

Disclosure: Nothing to disclose.

Additional Contributors

James W Patterson, MD Professor of Pathology and Dermatology, Director of Dermatopathology, University of Virginia Medical Center

James W Patterson, MD is a member of the following medical societies: American Academy of Dermatology, American College of Physicians, American Society of Dermatopathology, Royal Society of Medicine, Society for Investigative Dermatology, United States and Canadian Academy of Pathology

Disclosure: Nothing to disclose.


The authors and editors of Medscape Reference gratefully acknowledge the contributions of previous author, Kristiana Gray, MD, to the development and writing of this article.

  1. Millard PR, Young E, Harrison DE, Wojnarowska F. Reactive perforating collagenosis: light, ultrastructural and immunohistological studies. Histopathology. 1986 Oct. 10(10):1047-56. [Medline].

  2. Faver IR, Daoud MS, Su WP. Acquired reactive perforating collagenosis. Report of six cases and review of the literature. J Am Acad Dermatol. 1994 Apr. 30(4):575-80. [Medline].

  3. Morton CA, Henderson IS, Jones MC, Lowe JG. Acquired perforating dermatosis in a British dialysis population. Br J Dermatol. 1996 Nov. 135(5):671-7. [Medline].

  4. Poliak SC, Lebwohl MG, Parris A, Prioleau PG. Reactive perforating collagenosis associated with diabetes mellitus. N Engl J Med. 1982 Jan 14. 306(2):81-4. [Medline].

  5. Hoque SR, Ameen M, Holden CA. Acquired reactive perforating collagenosis: four patients with a giant variant treated with allopurinol. Br J Dermatol. 2006 Apr. 154(4):759-62. [Medline].

  6. Ramesh V, Sood N, Kubba A, Singh B, Makkar R. Familial reactive perforating collagenosis: a clinical, histopathological study of 10 cases. J Eur Acad Dermatol Venereol. 2007 Jul. 21(6):766-70. [Medline].

  7. Hafiji J, Hook CE, Burrows NP. Hyperkeratotic papules in a child with Down syndrome. Diagnosis: acquired reactive perforating collagenosis in Down syndrome. Pediatr Dermatol. 2011 Jan-Feb. 28(1):53-4. [Medline].

  8. Kim EJ, Kim MY, Kim HO, Park YM. Acquired reactive perforating collagenosis triggered by insect bite. J Dermatol. 2007 Sep. 34(9):677-9. [Medline].

  9. Ikezaki E, Sugita K, Kabashima K, Tokura Y. Scabies-induced acquired reactive perforating collagenosis. J Eur Acad Dermatol Venereol. 2008 Jan. 22(1):120-1. [Medline].

  10. Bovenmyer DA. Reactive perforating collagenosis. Experimental production of the lesion. Arch Dermatol. 1970 Sep. 102(3):313-7. [Medline].

  11. Kikuchi N, Ohtsuka M, Yamamoto T. Acquired Reactive Perforating Collagenosis: A Rare Association with Dermatomyositis. Acta Derm Venereol. 2013 Mar 5. [Medline].

  12. Kiliç A, Gönül M, Cakmak SK, Gül U, Demiriz M. Acquired reactive perforating collagenosis as a presenting sign of hepatocellular carcinoma. Eur J Dermatol. 2006 Jul-Aug. 16(4):447. [Medline].

  13. Chae KS, Park YM, Cho SH, Cho BK. Reactive perforating collagenosis associated with periampullary carcinoma. Br J Dermatol. 1998 Sep. 139(3):548-50. [Medline].

  14. Yazdi S, Saadat P, Young S, Hamidi R, Vadmal MS. Acquired reactive perforating collagenosis associated with papillary thyroid carcinoma: a paraneoplastic phenomenon?. Clin Exp Dermatol. 2009 May 5. [Medline].

  15. Calista D, Morri M. Acquired reactive perforating collagenosis induced by indinavir in 2 patients with HIV disease. Eur J Dermatol. 2008 Jan-Feb. 18(1):84-5. [Medline].

  16. Berger RS. Reactive perforating collagenosis of renal failure/diabetes responsive to topical retinoic acid. Cutis. 1989 Jun. 43(6):540-2. [Medline].

  17. Tilz H, Becker JC, Legat F, Schettini AP, Inzinger M, Massone C. Allopurinol in the treatment of acquired reactive perforating collagenosis*. An Bras Dermatol. 2013 Jan-Feb. 88(1):94-7. [Medline].

  18. Brinkmeier T, Schaller J, Herbst RA, Frosch PJ. Successful treatment of acquired reactive perforating collagenosis with doxycycline. Acta Derm Venereol. 2002. 82(5):393-5. [Medline].

  19. Vion B, Frenk E. [Acquired reactive collagen disease in the adult: successful treatment with UV-B light]. Hautarzt. 1989 Jul. 40(7):448-50. [Medline].

  20. Serrano G, Aliaga A, Lorente M. Reactive perforating collagenosis responsive to PUVA. Int J Dermatol. 1988 Mar. 27(2):118-9. [Medline].

  21. Sehgal VN, Verma P, Bhattacharya SN, Sharma S. Familial Reactive Perforating Collagenosis in a Child: Response to Narrow-Band UVB. Pediatr Dermatol. 2012 Apr 4. [Medline].

Typical keratotic papules.
Cup-shaped invagination of the epidermis associated with a keratin plug containing inflammatory debris and collagen fibers.
Vertically orientated collagen fibers are extruded into the overlying keratin plug.
An elastic van Gieson stain demonstrating the expulsion of collagen fibers (red) into the overlying keratin plug.
All material on this website is protected by copyright, Copyright © 1994-2016 by WebMD LLC. This website also contains material copyrighted by 3rd parties.