# An Unusual Presentation of Acquired Perforating Dermatosis Confined to the Scalp

## TL;DR

A 31-year-old man with kidney disease and diabetes developed a rare skin condition on his scalp, which improved with clindamycin and allopurinol treatment.

## Contribution

This case highlights an unusual scalp localization of acquired perforating dermatosis and effective treatment with clindamycin and allopurinol.

## Key findings

- APD lesions were confined to the scalp, an uncommon site for this condition.
- Histopathology confirmed transepidermal elimination of degenerated collagen bundles.
- Treatment with clindamycin and allopurinol led to complete resolution within one month.

## Abstract

Acquired perforating dermatosis (APD) is a rare skin disorder characterized by transepidermal elimination of dermal connective tissue components. We report the case of a 31-year-old man with end-stage renal disease on hemodialysis and type 1 diabetes mellitus who presented with APD lesions confined to the scalp, an uncommon site for this condition. Histopathological examination confirmed the diagnosis, revealing transepidermal elimination of degenerated collagen bundles. Sequential treatment with oral clindamycin followed by allopurinol resulted in marked clinical improvement and complete resolution within one month of therapy.