Acquired Perforating Dermatosis Associated with Hodgkin Lymphoma: Rare Associated Manifestation

Abstract

Acquired reactive perforating collagenosis (ARPC) is a rare subtype of acquired perforating dermatosis (APD) that typically occurs in adults, often associated with diabetes mellitus or chronic renal failure. However, ARPC has also been reported in association with malignancies and other systemic disorders. We presented the case of a 21-year-old Thai woman presented with multiple erythematous, pruritic papules with central keratotic plugs on the trunk, back, and extremities for five months. With history of chronic cough and significant weight loss of 10 kg over three months. Punch biopsy consistent with ARPC. Further investigations revealed an anterior mediastinal mass, multiple enlarged cervical and intraabdominal lymph nodes, and tiny pulmonary nodules with peribronchovascular consolidations at anterior segment of RUL; concerning for lymphatic or lung involvement. EBUS-guided biopsy showed atypical cells compatible with Classic Hodgkin lymphoma. The patient was diagnosed with ARPC with Hodgkin lymphoma stage IIIB with bulky disease, IPS 0. This case highlights the importance of recognizing ARPC as a potential cutaneous manifestation of underlying malignancy.