Papular Elastorrhexis: CASE REPORT

13 Jan
2011

A healthy 21-year-old woman presented with a 1- year history of multiple skin-colored papules on the upper back. The history of trauma to the lesions was unremarkable, except for excoriation due to an itching sensation. However, the papules had already been present several months before excoriation. She had no past history of acne and no family history of similar lesions or other skin diseases. The physical examination revealed multiple, white- colored papules dominantly on the upper back (Fig. 1). The lesions were nonfollicular and did not coalesce to form plaques.

fig.1 multiple

Fig. 1. Multiple, nonfollicular, white papules on the back.

A punch biopsy from a papule lesion revealed a focal area of thickened and homogenized collagen bundles in the reticular dermis, and perivascular lymphohistiocytic infiltration (Fig. 2A). Elastic tissue staining showed elastic fibers of the reticular dermis were intensively fragmented which resulted in a speckled appearance (Fig. 2B), but the perifollicular area do not show any changes. Congo- red staining revealed no amyloid deposition in the lesion. On the basis of the clinical and histopathologic findings, she was diagnosed as having PE.
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fig.2 A focal

Fig. 2. (A) Focal area of thickened, homogenized collagen bundles throughout the dermis (H&E, X 100). (B) Fragmentation of elastic fibers throughout the dermis (Elastic stain, X 100).

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