The two distinct forms of reactive perforating collagenosis are an inherited form that first appears in childhood and an acquired form that appears in adulthood. Reactive perforating collagenosis is a very rare skin disorder in which altered protein substance (collagen) is eliminated through the layer of skin (referred to as the epidermis).
Given that diabetic patients with renal failure who are receiving prolonged dialysis frequently experience it, it is also known as the itching of renal failure.
Collagen damage that is concentrated and then cleared through the epidermis is the main abnormality.
The acquired form typically affects patients with diabetes or chronic renal failure, especially those receiving dialysis. Acquired perforating collagenosis is more frequent, occurring in as many as 10% of patients receiving maintenance hemodialysis. The inherited form frequently involves cold or superficial blunt trauma as the primary cause of the lesions.
After they heal, the lesions leave some scarring and are extremely itchy.
The inherited form typically manifests in early childhood or infancy, while the acquired form happens in adults.
After minor trauma, small, asymptomatic keratotic papules appear; the lesions initially appear as pin-sized lesions, but over a few weeks they enlarge into larger papules, and they heal with minimal residual scarring.
A history of diabetes or renal failure is frequently brought up when discussing acquired perforating collagenosis, which is characterized by intense itching.
The most common sites for lesions are the extensor surfaces of the limbs and the dorsa of the hands, though they can also appear on the trunk and the face. Lesions are typically flesh-colored, dome-shaped papules as large as 10 mm in diameter with a keratinous plug.
There are other nephropathies besides diabetes that can develop acquired perforating collagenosis.
Acquired perforating collagenosis has been linked to conditions like lymphoma, periampullary carcinoma, hyperparathyroidism, hypothyroidism, and liver dysfunction.
Treatment:
Conventional treatment:
Topical steroids are typically ineffective, emollients and systemic antihistamines appear to be effective in reducing more intense itching, but conventional treatment of the lesions is frequently ineffective; in many cases, the lesions heal on their own but are frequently recurrent.
Homeopathic treatment:
Homeopathy is strongly recommended because it is expected to relieve the symptoms, particularly the intense itching and the skin lesions, and because reactive perforating collagenosis is a type of collagen disease for which homeopathy has good treatment to offer.
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