{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,30]],"date-time":"2026-06-30T05:46:34Z","timestamp":1782798394823,"version":"3.54.5"},"reference-count":30,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2026,6,30]],"date-time":"2026-06-30T00:00:00Z","timestamp":1782777600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100001809","name":"National Natural Science Foundation of China","doi-asserted-by":"publisher","award":["82505606"],"award-info":[{"award-number":["82505606"]}],"id":[{"id":"10.13039\/501100001809","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100005230","name":"Natural Science Foundation of Chongqing Municipality","doi-asserted-by":"publisher","award":["CSTB2025NSCQ-GPX1097, CSTB2023JXJL-YFX0028"],"award-info":[{"award-number":["CSTB2025NSCQ-GPX1097, CSTB2023JXJL-YFX0028"]}],"id":[{"id":"10.13039\/501100005230","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Immunol."],"abstract":"<jats:p>Acquired reactive perforating collagenosis (ARPC) is a rare disorder characterized by transepidermal expulsion of altered collagen, for which no standardized treatment is available. We present a case of a 67-year-old man with ARPC and significant comorbidities, including type 2 diabetes mellitus (T2DM), chronic hepatitis B (CHB), and impaired pulmonary function, who achieved rapid and substantial improvement in cutaneous lesions and pruritus after treatment with oral apremilast therapy. Notably, his comorbid conditions remained stable, and the clinical improvement persisted even after a seven-month drug-free follow-up period. This case highlights apremilast as a potentially effective and safe treatment option for ARPC, especially in patients unsuitable for conventional immunosuppressive therapy.<\/jats:p>","DOI":"10.3389\/fimmu.2026.1671943","type":"journal-article","created":{"date-parts":[[2026,6,30]],"date-time":"2026-06-30T05:37:44Z","timestamp":1782797864000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":0,"title":["Apremilast for acquired reactive perforating collagenosis with metabolic and infectious comorbidities: a case report"],"prefix":"10.3389","volume":"17","author":[{"given":"Fujun","family":"Huang","sequence":"first","affiliation":[{"name":"Department of Cosmetic Dermatology, Chongqing Traditional Chinese Medicine Hospital","place":["Chongqing, China"]},{"name":"Liaoning University of Traditional Chinese Medicine","place":["Shenyang, Liaoning, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lei","family":"Tang","sequence":"additional","affiliation":[{"name":"Department of Cosmetic Dermatology, Chongqing Traditional Chinese Medicine Hospital","place":["Chongqing, China"]},{"name":"Chengdu University of Traditional Chinese Medicine","place":["Chengdu, Sichuan, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mengya","family":"Huang","sequence":"additional","affiliation":[{"name":"Department of Cosmetic Dermatology, Chongqing Traditional Chinese Medicine Hospital","place":["Chongqing, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Qiang","family":"Fu","sequence":"additional","affiliation":[{"name":"Department of Cosmetic Dermatology, Chongqing Traditional Chinese Medicine Hospital","place":["Chongqing, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xun","family":"Zhou","sequence":"additional","affiliation":[{"name":"Department of Cosmetic Dermatology, Chongqing Traditional Chinese Medicine Hospital","place":["Chongqing, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Zhong","family":"Zhang","sequence":"additional","affiliation":[{"name":"Department of Dermatology, Chongqing Traditional Chinese Medicine Hospital","place":["Chongqing, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mingdan","family":"Zhao","sequence":"additional","affiliation":[{"name":"Department of Cosmetic Dermatology, Chongqing Traditional Chinese Medicine Hospital","place":["Chongqing, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2026,6,30]]},"reference":[{"key":"B1","doi-asserted-by":"publisher","first-page":"277","DOI":"10.1001\/archderm.1967.01610030055009","article-title":"Reactive perforating collagenosis","volume":"96","author":"Mehregan","year":"1967","journal-title":"Arch Dermatol"},{"key":"B2","doi-asserted-by":"publisher","DOI":"10.3390\/jcm15010391","article-title":"Acquired reactive perforating collagenosis\u2014a rare entity occurring within common disorders: a systematic review and our personal experience","volume":"15","author":"Junghetu","year":"2026","journal-title":"J Clin Med"},{"key":"B3","doi-asserted-by":"publisher","DOI":"10.1016\/S0190-9622(94)70065-6","article-title":"Acquired reactive perforating collagenosis","volume":"30","author":"Faver","year":"1994","journal-title":"J Am Acad Dermatol"},{"key":"B4","doi-asserted-by":"publisher","first-page":"446","DOI":"10.1001\/jamadermatol.2024.6280","article-title":"Tofacitinib for treatment of acquired reactive perforating collagenosis","volume":"161","author":"Yuan","year":"2025","journal-title":"JAMA Dermatol"},{"key":"B5","doi-asserted-by":"publisher","DOI":"10.3389\/fimmu.2024.1388274","article-title":"Effectiveness of baricitinib in acquired reactive perforating collagenosis: a case report","volume":"15","author":"Zheng","year":"2024","journal-title":"Front Immunol"},{"key":"B6","doi-asserted-by":"publisher","DOI":"10.1016\/j.jdcr.2025.07.005","article-title":"The treatment for acquired reactive perforating collagenosis with abrocitinib: a case report","volume":"64","author":"Liu","year":"2025","journal-title":"JAAD Case Rep"},{"key":"B7","doi-asserted-by":"publisher","DOI":"10.2147\/CCID.S502121","article-title":"Acquired reactive perforating collagenosis: clinicopathologic analysis of 12 cases","volume":"18","author":"Zhang","year":"2025","journal-title":"Clin Cosmet Investig Dermatol"},{"key":"B8","doi-asserted-by":"publisher","DOI":"10.1038\/s41584-024-01153-1","article-title":"JAK inhibitor selectivity: new opportunities, better drugs","volume":"20","author":"Virtanen","year":"2024","journal-title":"Nat Rev Rheumatol"},{"key":"B9","doi-asserted-by":"publisher","DOI":"10.1038\/s41584-022-00767-7","article-title":"Oral surveillance and JAK inhibitor safety: the theory of relativity","volume":"18","author":"Winthrop","year":"2022","journal-title":"Nat Rev Rheumatol"},{"key":"B10","doi-asserted-by":"publisher","DOI":"10.2147\/TCRM.S271058","article-title":"Doxycycline combined with NB-UVB phototherapy for acquired reactive perforating collagenosis","volume":"16","author":"Gao","year":"2020","journal-title":"Ther Clin Risk Manag"},{"key":"B11","doi-asserted-by":"publisher","DOI":"10.1093\/bjd\/ljaf173","article-title":"Mutation burden of narrowband ultraviolet B phototherapy (NB-UVB) in human skin: relevance to NB-UVB lifetime exposures and skin cancer surveillance","volume":"193","author":"Fowler","year":"2025","journal-title":"Br J Dermatol"},{"key":"B12","article-title":"Case report and analysis of allopurinol-caused ADR\/ADE in 60 patients","volume":"22","author":"Wu","year":"2013","journal-title":"Chin J New Drugs"},{"key":"B13","doi-asserted-by":"publisher","DOI":"10.4103\/ijd.ijd_328_21","article-title":"The effects of acitretin on insulin resistance, glucose metabolism, and lipid levels in patients with psoriasis","volume":"67","author":"Sachdev","year":"2022","journal-title":"Indian J Dermatol"},{"key":"B14","doi-asserted-by":"publisher","DOI":"10.1007\/BF00314862","article-title":"Effect of acitretin on the response to an intravenous glucose tolerance test in healthy volunteers","volume":"42","author":"Hartmann","year":"1992","journal-title":"Eur J Clin Pharmacol"},{"key":"B15","doi-asserted-by":"publisher","DOI":"10.3389\/fmed.2021.764216","article-title":"Reductive effect of acitretin on blood glucose levels in Chinese patients with psoriasis","volume":"8","author":"Qian","year":"2021","journal-title":"Front Med (Lausanne)"},{"key":"B16","doi-asserted-by":"publisher","DOI":"10.1016\/j.jdcr.2021.08.031","article-title":"Treatment of a perforating dermatosis with apremilast","volume":"16","author":"McMichael","year":"2021","journal-title":"JAAD Case Rep"},{"key":"B17","author":"Rice","year":"2026","journal-title":"Kyrle Disease"},{"key":"B18","author":"Mullins","year":"2026","journal-title":"Reactive Perforating Collagenosis"},{"key":"B19","author":"Harbaoui","year":"2026","journal-title":"Acquired Perforating Dermatosis"},{"key":"B20","doi-asserted-by":"publisher","DOI":"10.5826\/dpc.1402a100","article-title":"Acquired perforating dermatosis: clinical and histopathological analysis of 95 patients from one center","volume":"14","author":"Edek","year":"2024","journal-title":"Dermatol Pract Concept"},{"key":"B21","doi-asserted-by":"publisher","DOI":"10.1111\/1346-8138.15581","article-title":"Novel small\u2010insertion mutation in the LIPH gene in a patient with autosomal recessive woolly hair\/hypotrichosis","volume":"47","author":"Lv","year":"2020","journal-title":"J Dermatol"},{"key":"B22","doi-asserted-by":"publisher","DOI":"10.1016\/S0190-9622(84)80259-5","article-title":"The perforating disorders","volume":"10","author":"Patterson","year":"1984","journal-title":"J Am Acad Dermatol"},{"key":"B23","author":"Mullins","year":"2024","journal-title":"Reactive Perforating Collagenosis"},{"key":"B24","doi-asserted-by":"publisher","first-page":"69","DOI":"10.1016\/j.jdermsci.2023.04.003","article-title":"\u03bc-opioid receptor overexpression in acquired reactive perforating collagenosis associated with IL-31","volume":"110","author":"Kawakami","year":"2023","journal-title":"J Dermatol Sci"},{"key":"B25","doi-asserted-by":"publisher","first-page":"e750","DOI":"10.1111\/jdv.19864","article-title":"A giant variant of acquired reactive perforating collagenosis successfully treated with nemolizumab","volume":"38","author":"Yamada","year":"2024","journal-title":"J Eur Acad Dermatol Venereol"},{"key":"B26","doi-asserted-by":"publisher","DOI":"10.3389\/fimmu.2023.1240262","article-title":"Dupilumab improve acquired reactive perforating collagenosis characterized by type 2 inflammation","volume":"14","author":"Liu","year":"2023","journal-title":"Front Immunol"},{"key":"B27","doi-asserted-by":"publisher","DOI":"10.3389\/fimmu.2022.1068260","article-title":"JAK\u2013STAT signaling pathway in the pathogenesis of atopic dermatitis: an updated review","volume":"13","author":"Huang","year":"2022","journal-title":"Front Immunol"},{"key":"B28","doi-asserted-by":"publisher","first-page":"e14261","DOI":"10.1111\/dth.14261","article-title":"Apremilast in dermatology: a review of literature","volume":"33","author":"Nassim","year":"2020","journal-title":"Dermatol Ther"},{"key":"B29","doi-asserted-by":"publisher","DOI":"10.1007\/s40257-019-00457-3","article-title":"Managing psoriasis in patients with HBV or HCV infection: practical considerations","volume":"20","author":"Piaserico","year":"2019","journal-title":"Am J Clin Dermatol"},{"key":"B30","doi-asserted-by":"publisher","DOI":"10.1007\/s40272-024-00668-0","article-title":"Apremilast: first pediatric approval","volume":"27","author":"Blair","year":"2025","journal-title":"Pediatr Drugs"}],"container-title":["Frontiers in Immunology"],"original-title":[],"link":[{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fimmu.2026.1671943\/full","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,6,30]],"date-time":"2026-06-30T05:37:45Z","timestamp":1782797865000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fimmu.2026.1671943\/full"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,6,30]]},"references-count":30,"alternative-id":["10.3389\/fimmu.2026.1671943"],"URL":"https:\/\/doi.org\/10.3389\/fimmu.2026.1671943","relation":{},"ISSN":["1664-3224"],"issn-type":[{"value":"1664-3224","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,6,30]]},"article-number":"1671943"}}