Keywords: acquired reactive perforating collagenosis, perforating dermatosis, diabetic nephropathy, chronic renal failure, hemodialysis 〈Abstract〉 A 51 year old female with type Ⅱ diabetes mellitus and end stage kidney disease undergoing hemodialysis presented with scattered, itchy skin lesions with umbilicated papules, sticked keratin, and a fixed crust, primarily located on the face, trunk, and tensor surfaces of the limbs, around 2017. Topical ointments had been ineffective. As acquired reactive perforating collagenosis (ARPC) was strongly suspected by a dermatologist, steroid ointment and antiallergic agents were prescribed. Additionally, minocycline (200 mg/day) was administered for ARPC. Severe pruritus and skin lesions were improved by these treatments. It is important to consider ARPC as a differential diagnosis of pruritus among patients on dialysis, and minocycline may be an effective treatment option.