mid-dermal elastolysis

Etiology

• idiopathic
• reported associations
  • ultraviolet radiation exposure
  • pregnancy
  • oral contraceptive use
  • dermatitis
  • autoimmune diseases

Epidemiology

• rare
• female Caucasians

Pathology

• may appear normal or with inflammatory infiltrate on H&E stain
• focal loss of elastic fiber may be seen

Clinical manifestations

• distribution:
  • trunk & upper arms most common
  • face & lower legs are only occasionally affected
• type 1: (most common)
  • asymptomatic, well-demarcated areas of fine wrinkling
• type 2:
  • looseness of skin around hair follicles, resulting in perifollicular papules
• type 3: reticular erythema

* images

Management

• sunscreen
• topical retinoids

More general terms

• cutis laxa; elastolysis; loose skin; pachydermatocele