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

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.