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Cutaneous Elastic Tissue Anomalies

Andrés-Ramos, Irene, MD*; Alegría-Landa, Victoria, MD*; Gimeno, Ignacio, MD*; Pérez-Plaza, Alejandra, MD*; Rütten, Arno, MD; Kutzner, Heinz, MD; Requena, Luis, MD*

The American Journal of Dermatopathology: February 2019 - Volume 41 - Issue 2 - p 85–117
doi: 10.1097/DAD.0000000000001275
CME Article

Abstract: After a review of the physiology in the formation and degradation of cutaneous elastic tissue, we describe the clinicopathologic disorders characterized by increased and decreased cutaneous elastic tissue. Cutaneous disorders characterized by increased and/or abnormal elastic tissue in the dermis include elastoma, also named nevus elasticus, dermatosis lenticularis disseminata, pseudoxanthoma elasticum, late-onset focal dermal elastosis, linear focal elastosis, elastoderma, elastofibroma dorsi, and elastosis perforans serpiginosa. In some of these conditions, the specific histopathologic diagnosis may be rendered with hematoxylin-eosin stain, whereas in other ones special elastic tissue stains are necessary to demonstrate the anomalies. Cutaneous disorders characterized by decreased dermal elastic tissue include nevus anelasticus, papular elastorrhexis, perifollicular elastolysis, anetoderma cutis laxa, postinflammatory elastolysis and cutis laxa, white fibrous papulosis of the neck, pseudoxanthoma elasticum–like papillary dermal elastolysis, and mid dermal elastolysis. In most of these conditions, the histopathologic anomalies are only seen with elastic tissue stains, and cutaneous biopsies of these processes stained with hematoxylin-eosin show appearance of normal skin. The diagnosis of some of these disorders characterized by increased or decreased elastic dermal tissue should be followed by general exploration of the patient to rule out associated severe systemic anomalies, and in some cases, a genetic counseling should be offered to the family.

*Department of Dermatology, Fundación Jiménez Díaz, Universidad Autónoma, Madrid, Spain; and

Dermatopathology Laboratorie, Friedrichschafen, Germany.

Correspondence: Luis Requena, MD, Department of Dermatology, Fundación Jiménez Díaz, Av. Reyes Católicos 2, 28040 Madrid, Spain (e-mail:

All authors and staff in a position to control the content of this CME activity and their spouses/life partners (if any) have disclosed that they have no financial relationships with, or financial interests in, any commercial organizations relevant to this educational activity.

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