Reactive perforating collagenosis (RPC) is a rare disorder characterized by transepidermal elimination of altered collagen. The acquired form of RPC manifests in adult life and is accompanied by general pruritus and scratching. Diabetes mellitus and end-stage renal disease are frequently associated with RPC. We describe a case of RPC developing after pulmonary aspergillosis in a 54-year-old man with long-standing insulin-dependent diabetes and discuss possible etiologic relations.