Acquired reactive perforating collagenosis in skin of color

Acquired reactive perforating collagenosis is an uncommon disorder that present as keratotic plugs on the skin owing to transepidermal perforation of dermal connective tissue. Etiology is unclear, although the condition has been associated with renal disease, diabetes, and HIV. It can frequently be misdiagnosed and lead to significant impact on quality of life, particularly in patients with skin of color. Herein, we present an skin of color patient with this condition who experienced severe pruritus over years before receiving a definitive diagnosis. Clobetasol improved her condition and quality of life over several months.