Acquired reactive perforating collagenosis in an insulin dependent diabetes mellitus patient

Acquired reactive perforating collagenosis is a skin disorder characterised by the transepidermal elimination of altered collagen through the epidermis. Two distinct forms exist; an inherited form that present in childhood resulting from superficial trauma, scratching, insect bite, etc., and an acquired form that usually develops de novo in patients suffering from many chronic systemic and auto-immune diseases without any minor injury. Here a 36-year-old, insulin dependent diabetes mellitus patient with acquired variety of reactive perforating collagenosis and lipodystrophy at the sites of insulin injection sites is presented. Isotretinoin 0.1% cream was advised but with little improvement.