{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,20]],"date-time":"2026-03-20T13:36:45Z","timestamp":1774013805230,"version":"3.50.1"},"reference-count":18,"publisher":"PAGEPress Publications","issue":"1","license":[{"start":{"date-parts":[[2024,10,3]],"date-time":"2024-10-03T00:00:00Z","timestamp":1727913600000},"content-version":"unspecified","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc\/4.0"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Dermatol Reports"],"abstract":"<jats:p>Bullous pemphigoid (BP) is a common autoimmune blistering disorder with unknown aetiology. During the last decades, its association with various common comorbidities, including cardiovascular, metabolic, neuropsychiatric, and neoplastic disorders, has been established. However, in recent years, an increasing number of BP cases have also been reported in association with rarer diseases, including acquired reactive perforating collagenosis (ARPC). Patients with coexisting BP and ARPC have been reported to share common clinical features, including metabolic comorbidities, e.g., diabetes mellitus (DM). As the evolution from ARPC cutaneous involvement to classic BP lesions has been more frequently described, it has been suggested that it may represent a new clinical variant of BP with a specific pathogenetic background. Here is reported a challenging case in which a typical onset of BP was later followed by the eruption of atypical ARPC lesions in a patient with multiple non-compensated metabolic and cardiovascular comorbidities.<\/jats:p>","DOI":"10.4081\/dr.2024.10087","type":"journal-article","created":{"date-parts":[[2024,10,3]],"date-time":"2024-10-03T10:43:43Z","timestamp":1727952223000},"source":"Crossref","is-referenced-by-count":0,"title":["Bullous pemphigoid with secondary acquired reactive perforating collagenosis: a challenging clinical case report"],"prefix":"10.4081","volume":"17","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-0307-6636","authenticated-orcid":false,"given":"Valentina","family":"Ruffo di Calabria","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0388-1037","authenticated-orcid":false,"given":"Elena Biancamaria","family":"Mariotti","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Alberto","family":"Corr\u00e0","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Alice","family":"Verdelli","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9228-8042","authenticated-orcid":false,"given":"Lavinia","family":"Quintarelli","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Cristina","family":"Aimo","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6106-599X","authenticated-orcid":false,"given":"Giovanni","family":"Di Zenzo","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Vincenza","family":"Maio","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5688-5923","authenticated-orcid":false,"given":"Daniela","family":"Massi","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7471-3471","authenticated-orcid":false,"given":"Marzia","family":"Caproni","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"2549","published-online":{"date-parts":[[2024,10,3]]},"reference":[{"key":"19557","doi-asserted-by":"crossref","unstructured":"Mehregan A, Schwartz OD, Livingood CS. Reactive Perforating Collagenosis. Arch Dermatol. 1967;96:277-82.","DOI":"10.1001\/archderm.96.3.277"},{"key":"19558","doi-asserted-by":"crossref","unstructured":"Rapini R, Herbert AA, Drucker CR. Acquired perforating dermatosis. Evidence for combined transepidermal elimination of both collagen and elastic fibers. Arch Dermatol. 1989;125:1074-8.","DOI":"10.1001\/archderm.125.8.1074"},{"key":"19559","doi-asserted-by":"crossref","unstructured":"Karpouzis A, Giatromanolaki A, Sivridis E, Kouskoukis C. Acquired reactive perforating collagenosis: current status. J Dermatol. 2010;37:585-92.","DOI":"10.1111\/j.1346-8138.2010.00918.x"},{"key":"19560","doi-asserted-by":"crossref","unstructured":"Patel S, Ahsanuddin S, Cadwell JB, Lambert WC. The impact of diabetes mellitus on medical complication and mortality rates among inpatients with bullous pemphigoid. Ir J Med Sci. 2022;191:1669-75.","DOI":"10.1007\/s11845-021-02726-9"},{"key":"19561","doi-asserted-by":"crossref","unstructured":"Borradori L, Van Beek N, Feliciani C, et al. Updated S2 K guidelines for the management of bullous pemphigoid initiated by the European Academy of Dermatology and Venereology (EADV). J Eur Acad Dermatol Venereol. 2022;36:1689-704.","DOI":"10.1111\/jdv.18220"},{"key":"19562","doi-asserted-by":"crossref","unstructured":"Theodoridis A, Makrantonaki E, Zouboulis C. Malignant atrophic papulosis (K\u00f6hlmeier-Degos disease) - A review. Orphanet J Rare Dis. 2013;8:10.","DOI":"10.1186\/1750-1172-8-10"},{"key":"19563","doi-asserted-by":"crossref","unstructured":"Ormerod E, Atwan A, Intzedy L, Stone N. Dermoscopy features of acquired reactive perforating collagenosis: a case series. Dermatol Pract Concept. 2018;8:303-5.","DOI":"10.5826\/dpc.0804a11"},{"key":"19564","doi-asserted-by":"crossref","unstructured":"Geiss Steiner J, Tr\u00fceb RM, Kerl K, et al. Ecthyma-gangrenosum-like bullous pemphigoid. Dermatol. 2010;221:142-8.","DOI":"10.1159\/000316098"},{"key":"19565","doi-asserted-by":"crossref","unstructured":"Tani S, Ishii N, Hashimoto T, Tsujioka K. Bullous pemphigoid arising in a patient with acquired perforating dermatosis. Clin Exp Dermatol. 2017;42:406-9.","DOI":"10.1111\/ced.13080"},{"key":"19566","doi-asserted-by":"crossref","unstructured":"Nomura H, Mukai M, Niimi Y, et al. Coexistence of acquired perforating dermatosis and bullous pemphigoid: three cases. Eur J Dermatol. 2017;27:192-3.","DOI":"10.1684\/ejd.2016.2944"},{"key":"19567","doi-asserted-by":"crossref","unstructured":"Maki N, Nishie W, Takazawa M, et al. Dipeptidyl peptidase-4 inhibitor-associated bullous pemphigoid in a patient with acquired reactive perforating collagenosis. J Dermatol. 2018;45:600-2.","DOI":"10.1111\/1346-8138.14254"},{"key":"19568","doi-asserted-by":"crossref","unstructured":"Schauer F, Kern JS, Virtic O, et al. A new clinical variant of acquired reactive perforating dermatosis-like bullous pemphigoid. Br J Dermatol. 2019;180:231-2.","DOI":"10.1111\/bjd.17146"},{"key":"19569","doi-asserted-by":"crossref","unstructured":"Gambichler T, Espey B, Doerler M, Stranzenbach R. Dipeptidyl peptidase-4 inhibitor induced bullous pemphigoid complicated by acquired reactive perforating dermatosis. Actas Dermosifiliogr. 2022;113:914-5.","DOI":"10.1016\/j.ad.2021.01.023"},{"key":"19570","doi-asserted-by":"crossref","unstructured":"Salemme A, Fania L, Scarabello A, et al. Gliptin-associated bullous pemphigoid shows peculiar features of anti-BP180 and -BP230 humoral response: Results of a multicenter study. J Am Acad Dermatol. 2022;87:56-63.","DOI":"10.1016\/j.jaad.2022.02.036"},{"key":"19571","doi-asserted-by":"crossref","unstructured":"Schmidt E, Spindler V, Eming R, et al. Meeting report of the pathogenesis of pemphigus and pemphigoid meeting in Munich, September 2016. J Invest Dermatol. 2017;137:1199-203.","DOI":"10.1016\/j.jid.2017.01.028"},{"key":"19572","doi-asserted-by":"crossref","unstructured":"Garc\u00eda-Malinis AJ, Del Valle S\u00e1nchez E, S\u00e1nchez-Salas MP, et al. Acquired perforating dermatosis: clinicopathological study of 31 cases, emphasizing pathogenesis and treatment. J Eur Acad Dermatol Venereol. 2017;31:1757-63.","DOI":"10.1111\/jdv.14220"},{"key":"19573","doi-asserted-by":"crossref","unstructured":"Kim S, Kim M, Lee JH, et al. A clinicopathologic study of thirty cases of acquired perforating dermatosis in Korea. Ann Dermatol. 2014;26:162.","DOI":"10.5021\/ad.2014.26.2.162"},{"key":"19574","doi-asserted-by":"crossref","unstructured":"Bellinato F, Maurelli M, Gisondi P, Girolomoni G. Acquired perforating dermatoses show increased levels of cutaneous advanced glycation end\u2010products. 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