title: Acquired perforating dermatosis: clinicopathological study of 31 cases, emphasizing pathogenesis and treatment.
abstract: BACKGROUND
  Acquired perforating dermatosis (APD) is a rare group of skin disorders of unknown aetiology and pathogenesis and is associated with several systemic diseases.
  
  
  OBJECTIVE
  We review the clinicopathological features, associated systemic diseases and treatment response in a series of APD patients.
  
  
  METHODS
  We conducted a retrospective observational study of all patients histologically diagnosed with APD in Hospital San Jorge (Huesca, Spain) between 2002 and 2014. Demographic and clinical features were collected from medical records. Statistical analyses were carried out using SPSS software (version 20.0; IBM Corp, Armonk, NY, USA).
  
  
  RESULTS
  The study population consisted of 31 patients (19 women and 12 men), with a mean age of 54 years. Reactive perforating collagenosis (n = 15, 45%) was the most common histopathologic type. The most frequently affected area was the lower limbs (66.6%, n = 22), and pruritus was present in 19 patients (61.3%, P = 0.005). Arterial hypertension (30.3%) was the most common associated condition. Five patients were receiving treatment with infliximab when diagnosed with APD. Most patients responded to topical steroids and oral antihistamines (n = 15).
  
  
  CONCLUSIONS
  This study is retrospective, and the sample size is limited.
  
  
  CONCLUSIONS
  Acquired perforating dermatosis is an underdiagnosed dermatosis frequently associated with systemic disorders. Its pathogenesis may involve vascular damage, not only in patients with diabetes, but also in those with arterial hypertension and chronic venous insufficiency. Control of pruritus and underlying extracutaneous disorders, as well as discontinuation of the treatment with biologics, are important aspects of the management of this dermatosis.
authors.affiliation: Unit of Dermatology, Hospital San Jorge, Huesca, Spain.
authors.forename: A J
authors.initials: AJ
authors.lastname: García-Malinis
authors.affiliation: Department of Pathology, Hospital San Jorge, Huesca, Spain.
authors.forename: E
authors.initials: E
authors.lastname: Del Valle Sánchez
authors.affiliation: Unit of Dermatology, Hospital de Barbastro, Huesca, Spain.
authors.forename: M P
authors.initials: MP
authors.lastname: Sánchez-Salas
authors.affiliation: Unit of Dermatology, Hospital San Jorge, Huesca, Spain.
authors.forename: E
authors.initials: E
authors.lastname: Del Prado
authors.affiliation: Unit of Dermatology, Hospital San Jorge, Huesca, Spain.
authors.forename: C
authors.initials: C
authors.lastname: Coscojuela
authors.affiliation: Unit of Dermatology, Hospital San Jorge, Huesca, Spain.
authors.forename: Y
authors.initials: Y
authors.lastname: Gilaberte
mesh_terms: D000305:Adrenal Cortex Hormones / Q000627:therapeutic use*; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D006633:Histamine Antagonists / Q000627:therapeutic use*; D006801:Humans; D000069285:Infliximab / Q000627:therapeutic use*; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D012871:Skin Diseases / Q000150:complications / Q000188:drug therapy* / Q000209:etiology*; D016896:Treatment Outcome; D055815:Young Adult
chemical_list: D000305:Adrenal Cortex Hormones; D006633:Histamine Antagonists; D000069285:Infliximab