Correspondence| Volume 253, P339-341, October 2020

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Acquired reactive perforating collagenosis in association with pregnancy

      A 32 year-old woman, at 17 weeks gestation, presented to dermatology with a pruritic erythematous urticarial-like eruption present on the trunk and limbs. A diagnosis of polymorphic eruption of pregnancy (PEP) was made and the patient was referred for ultraviolet B TL01 phototherapy. However at 24 weeks gestation, a separate papular eruption on the forearms and lower limbs was noted, mainly appearing at sites of superficial trauma. This eruption then evolved into tender, umbilicated nodules with a central keratin plug, in keeping with acquired reactive perforating collagenosis (ARPC) (Fig. 1). Phototherapy had not yet commenced at this stage. Histological evaluation revealed cup-shaped invagination of the epidermis with keratinous material along with evidence of transepidermal elimination of collagen, confirming the clinical diagnosis. The patient subsequently commenced phototherapy to treat both the PEP and ARPC, with clinical improvement.
      Fig. 1
      Fig. 1Umbilicated nodules with a central keratin plug.
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