Academic Journal
Effectiveness of sodium thiosulfate in acquired reactive perforating collagenosis: A case report.
| Τίτλος: | Effectiveness of sodium thiosulfate in acquired reactive perforating collagenosis: A case report. |
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| Συγγραφείς: | Zhu B; Department of Nephrology, No. 903 Hospital of PLA Joint Logistic Support Force, Hangzhou, China., Zhu K; Department of Nephrology, No. 903 Hospital of PLA Joint Logistic Support Force, Hangzhou, China., Pan L; Department of Nephrology, No. 903 Hospital of PLA Joint Logistic Support Force, Hangzhou, China., Guan X; Department of Nephrology, No. 903 Hospital of PLA Joint Logistic Support Force, Hangzhou, China., Zhu X; Department of Nephrology, No. 903 Hospital of PLA Joint Logistic Support Force, Hangzhou, China., Wu C; Department of Nephrology, No. 903 Hospital of PLA Joint Logistic Support Force, Hangzhou, China., Shen S; Department of Dermatology, No. 903 Hospital of PLA Joint Logistic Support Force, Hangzhou, China. |
| Πηγή: | Medicine [Medicine (Baltimore)] 2026 Jan 09; Vol. 105 (2), pp. e46992. |
| Τύπος έκδοσης: | Journal Article; Case Reports |
| Γλώσσα: | English |
| Στοιχεία περιοδικού: | Publisher: Lippincott Williams & Wilkins Country of Publication: United States NLM ID: 2985248R Publication Model: Print Cited Medium: Internet ISSN: 1536-5964 (Electronic) Linking ISSN: 00257974 NLM ISO Abbreviation: Medicine (Baltimore) Subsets: MEDLINE |
| Imprint Name(s): | Original Publication: Hagerstown, Md : Lippincott Williams & Wilkins |
| Ιατρικοί όροι (MeSH): | Thiosulfates*/therapeutic use , Thiosulfates*/administration & dosage , Kidney Failure, Chronic*/complications , Kidney Failure, Chronic*/therapy , Collagen Diseases*/drug therapy , Collagen Diseases*/etiology, Renal Dialysis/adverse effects ; Pruritus/drug therapy ; Pruritus/etiology ; Diabetes Mellitus, Type 2/complications ; Humans ; Male ; Aged ; Treatment Outcome |
| Περίληψη: | Rationale: Acquired reactive perforating collagenosis (ARPC) is a challenging dermatological complication in end-stage renal disease (ESRD) patients on hemodialysis, characterized by transepidermal elimination of degenerated collagen and intense pruritus. Treatment options are limited and lack consensus. Based on its established safety profile in ESRD and pathophysiological rationale, we evaluated sodium thiosulfate (STS) as a novel therapeutic option for ARPC. Patient Concerns: A 70-year-old male with ESRD on hemodialysis and type 2 diabetes presented with widespread pruritic papules consistent with ARPC. Diagnoses: The diagnosis of ARPC was confirmed histologically by Masson trichrome staining. Interventions: After unsatisfactory responses to topical steroids and antihistamines, intravenous STS (3.2 g after hemodialysis, 3 times weekly) was initiated. Outcomes: The patient showed marked clinical improvement in pruritus and skin lesions within 1 month, with a corresponding decrease in eosinophil count and IgE levels. No adverse effects, such as metabolic acidosis or gastrointestinal symptoms, were observed. Lessons: STS may be an effective and well-tolerated treatment for ARPC in hemodialysis patients. The observed immunomodulatory changes, though possibly related to symptom resolution, support further investigation into its mechanism of action. (Copyright © 2026 the Author(s). Published by Wolters Kluwer Health, Inc.) |
| Competing Interests: | The authors have no conflicts of interest to disclose. |
| References: | Wagner G, Sachse MM. Acquired reactive perforating dermatosis. J Dtsch Dermatol Ges. 2013;11:723–9, 723. Faver IR, Daoud MS, Su WP. Acquired reactive perforating collagenosis. Report of six cases and review of the literature. J Am Acad Dermatol. 1994;30:575–80. Karpouzis A, Giatromanolaki A, Sivridis E, Kouskoukis C. Acquired reactive perforating collagenosis: current status. J Dermatol. 2010;37:585–92. Zhang X, Yang Y, Shao S. Acquired reactive perforating collagenosis: a case report and review of the literature. Medicine (Baltimore). 2020;99:e20391. Poliak SC, Lebwohl MG, Parris A, Prioleau PG. Reactive perforating collagenosis associated with diabetes mellitus. N Engl J Med. 1982;306:81–4. Hood AF, Hardegen GL, Zarate AR, Nigra TP, Gelfand MC. Kyrle’s disease in patients with chronic renal failure. Arch Dermatol. 1982;118:85–8. Hurwitz RM, Melton ME, Creech FT 3rd, Weiss J, Handt A. Perforating folliculitis in association with hemodialysis. Am J Dermatopathol. 1982;4:101–8. Morton CA, Henderson IS, Jones MC, Lowe JG. Acquired perforating dermatosis in a British dialysis population. Br J Dermatol. 1996;135:671–7. Kim D, Pollock C. Epidemiology and burden of chronic kidney disease-associated pruritus. Clin Kidney J. 2021;14:i1–7. Akoglu G, Sungu N, Karaismailoglu E, Aktas A. Expression of the receptor for advanced glycation end products in acquired reactive perforating collagenosis. Indian J Dermatol Venereol Leprol. 2017;83:432–5. Kim SW, Kim MS, Lee JH, et al. A clinicopathologic study of thirty cases of acquired perforating dermatosis in Korea. Ann Dermatol. 2014;26:162–71. Bejjanki H, Siroy AE, Koratala A. Reactive perforating collagenosis in end-stage renal disease: not all that itches is uremic pruritis! Am J Med. 2019;132:e658–60. Kim EJ, Kim MY, Kim HO, Park YM. Acquired reactive perforating collagenosis triggered by insect bite. J Dermatol. 2007;34:677–9. Kreuter A, Gambichler T. Acquired reactive perforating collagenosis. CMAJ. 2010;182:E184. Miyanaga M, Oyama N, Sakai Y, Imamura Y, Hasegawa M. Successful treatment of acquired reactive perforating collagenosis with topical benzoyl peroxide: a possible therapeutic action underlying structural and metabolic turnover. J Dermatol. 2020;47:e12–4. Liu B, Wu Y, Wu X, Zhong X, Xue R, Zhang Z. Dupilumab improve acquired reactive perforating collagenosis characterized by type 2 inflammation. Front Immunol. 2023;14:1240262. Ying Y, Shuang C, Zhen-Ying Z. Dupilumab may be an alternative option in the treatment of acquired reactive perforating collagenosis combined with AD. Immun Inflamm Dis. 2022;10:e574. Zheng J, Ding Y, Chen Y, Shi Y, Gao Y. Effectiveness of baricitinib in acquired reactive perforating collagenosis: a case report. Front Immunol. 2024;15:1388274. Cicone JS, Petronis JB, Embert CD, Spector DA. Successful treatment of calciphylaxis with intravenous sodium thiosulfate. Am J Kidney Dis. 2004;43:1104–8. Hayden MR, Goldsmith DJ. Sodium thiosulfate: new hope for the treatment of calciphylaxis. Semin Dial. 2010;23:258–62. Song YH, Wang SY, Lang JH, Xiao YF, Cai GY, Chen XM. Therapeutic effect of intravenous sodium thiosulfate for uremic pruritus in hemodialysis patients. Ren Fail. 2020;42:987–93. Zanardo RC, Brancaleone V, Distrutti E, Fiorucci S, Cirino G, Wallace JL. Hydrogen sulfide is an endogenous modulator of leukocyte-mediated inflammation. FASEB J. 2006;20:2118–20. Altman K, Shinohara M. Demographics, comorbid conditions, and outcomes of patients with nonuremic calciphylaxis. JAMA Dermatol. 2019;155:251–2. |
| Contributed Indexing: | Keywords: Th2-type inflammation; acquired reactive perforating collagenosis; case report; renal dialysis; sodium thiosulfate |
| Substance Nomenclature: | 0 (Thiosulfates) HX1032V43M (sodium thiosulfate) |
| Entry Date(s): | Date Created: 20260110 Date Completed: 20260110 Latest Revision: 20260626 |
| Update Code: | 20260626 |
| PubMed Central ID: | PMC12794958 |
| DOI: | 10.1097/MD.0000000000046992 |
| PMID: | 41517726 |
| Βάση Δεδομένων: | MEDLINE |
| ISSN: | 1536-5964 |
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| DOI: | 10.1097/MD.0000000000046992 |