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ISSN: 1642-395X
Advances in Dermatology and Allergology/Postępy Dermatologii i Alergologii
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vol. 36
Letter to the Editor

A case of papular elastorrhexis

Meng Jiang, Wenbo Bu, Xu Chen, Heng Gu

Adv Dermatol Allergol 2019; XXXVI (1): 117-118
Online publish date: 2019/02/22
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An 11-year-old girl presented with a 2-year history of flesh-colored papules on her extremities (Figure 1). The lesions were asymptomatic, of oval or irregular shape and increased gradually both in size and numbers without any treatment. She denied a history of any other inflammatory dermatoses or trauma on the involved area. There was no family history of similar lesions. Dermatological examination showed that multiple flesh-colored, non-follicular papules were discrete and distributed over her lower limbs. The lesions were approximately 5–10 mm
in diameter, of various shapes and slightly hard. No other primary or secondary lesions (erythema or scales, etc.) can be seen around the involved area. Histopathological examination of the skin lesion on the left thigh revealed hyperkeratosis, slight perivascular lymphocytes infiltration and a mild hyperplasia of collagen fiber in the dermis. Elastic tissue staining (Resorcinol-Fuchsin stain) showed a significant reduction, fragmentation or complete loss of elastic tissue in upper and mid dermis (Figure 2). Based on the clinical and histopathological features, a diagnosis of papular elastorrhexis was made. No treatment was performed because of the benign process of this disease and asymptomatic character of the lesions. She was followed up for one year and showed no improvement in the involved lesions.
Papular elastorrhexis (PE) is a rare acquired elastic tissue disorder which was first described by Bordas et al. [1] in 1987. The etiology of this disease is still unclear. Papular elastorrhexis usually occurs in children or adolescents with a predilection for women. Its clinical characteristics are multiple asymptomatic, non-follicular flesh-colored papules, between 3 and 5 mm in size. Papules are firm and mainly distributed over the trunk or upper extremities with no fusion. In addition, there is no osteopoikilosis or similar family history and usually occurs without any previous history of acne, inflammation or trauma. The prominent histopathological feature of PE is the reduction, fragmentation or complete loss of dermal elastic fibers. Collagen fibers can be normal, focally thickened or even homogenized with a few lymphocytes infiltrated around the blood vessels [2].
Papular elastorrhexis has not received a well-recognized division and it is still controversial whether PE is a distinct entity or a variant of nevus anelasticus (NA) or abortive form of Buschke-Ollendorff...

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Bordas X, Ferrandiz C, Ribera M, et al. Papular elastorrhexis: a variety of nevus anelasticus? Arch Dermatol 1987; 123: 433-4.
Buechner SA, Itin P. Papular elastorrhexis. report of five cases. Dermatology 2002; 205: 198-200.
Schirren H, Schirren CG, Stolz W, et al. Papular elastorrhexis: a variant of dermatofibrosis lenticularis disseminata (Buschke-Ollendorff syndrome)? Dermatology 1994; 189: 368-72.
Lewis KG, Bercovitch L, Dill SW, et al. Acquired disorders of elastic tissue: Part II. decreased elastic tissue. J Am Acad Dermatol 2004; 51: 165-85; quiz 186-168.
Luo DQ, Liu JH, Chen MC, et al. Papular elastorrhexis: report of four cases and review of literature. Arch Dermatol Res 2015; 307: 99-108.
Lee SH, Park SH, Song KY, et al. Papular elastorrhexis in childhood improved by intralesional injections of triamcinolone. J Dermatol 2001; 28: 569-71
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