Acquired perforating dermatosis (APD) is characterized by pruritic craterlike lesions with a predilection for patients affected by chronic kidney disease or diabetes mellitus (DM). We present a case of a 57-year-old black woman admitted for chest pain and dyspnea who was found to have 2 teardrop-shaped yellow-white-chalky plaques consistent with APD that developed at the site of a preexisting split-thickness skin graft (STSG). We also review the literature on APD.

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