A 37-year-old Filipino man presented with a 9-month history of sagging skin progressing cephalocaudally from the chin and neck to the axillae, side of the trunk, and pelvic area. This was followed by a 2-month history of increasing serum creatinine levels associated with periorbital and bipedal edema, generalized weakness, decreased appetite, vomiting, and headache. Subsequently, skin-colored, non-tender sac-like plaques appeared on the abdomen, inguinal, and intergluteal areas. Histopathology of the latter lesions showed increased spaces between collagen bundles in the dermis. Staining with Verhoeff-van Gieson revealed focal sparse elastic fibers in the papillary dermis compared to that of the reticular dermis consistent with anetoderma. Further work-up revealed normal ANA titer and low serum C3. Kidney biopsy showed IgG deposition in the tubular basement membrane and trace C3 deposition in the glomerular mesangium, giving a diagnosis of rapid progressive glomerulonephritis. On subsequent follow-up, the sac-like plaques became lax and presented as generalized wrinkling of the skin, raising the question whether cutis laxa and anetoderma are occurring in a spectrum instead as distinct entities. Based on the current review of literature, this is the first reported case of primary anetoderma co-occurring with cutis laxa in a patient with glomerulonephritis. Deposition of immunoglobulins along the elastic fibers could have activated the complement system, mediating the destruction of the elastic fibers, resulting to cutis laxa and anetoderma. This case also considers the possibility of anetoderma and type I acquired cutis laxa occurring either in a spectrum or as distinct diseases in a single patient. Further investigations may identify an ultrastructural pattern that can help differentiate the two entities.
Anetoderma ; Cutis Laxa ; Glomerulonephritis

Anetoderma is a rare cutaneous disorder characterized by a loss of normal elastic tissue that presents clinically as atrophic patches located mainly on the upper trunk. Recent studies suggest immunological mechanisms may play a role in this process. Furthermore, a secondary form of macular atrophy occurs in the course of infectious diseases (e.g. syphilis and tuberculosis) and autoimmune disease (e.g. systemic lupus erythematosus [SLE]). Here, we report the case of a 20-year-old woman previously diagnosed with SLE, who presented with numerous well-circumscribed atrophic macules on the face and upper trunk. Histopathological examination showed decreased elastic tissues in the reticular dermis and mononuclear cells adhering to elastic fibers, consistent with anetoderma. Thus, the eruptive anetoderma localized widely on the face and upper trunk may have been caused by an autoimmune response of SLE.
Anetoderma* ; Atrophy ; Autoimmune Diseases ; Autoimmunity ; Communicable Diseases ; Dermis ; Elastic Tissue ; Female ; Humans ; Lupus Erythematosus, Systemic* ; Syphilis ; Young Adult

No abstract available.
Anetoderma* ; Granuloma Annulare* ; Humans ; Infant*

Anetoderma is characterized by a loss of normal elastic tissue, and is clinically presented as atrophic patches located mainly on the upper trunk. It may be primary or secondary, occurring in the course of various dermatoses. The most common diseases among them are acne and varicella, but there are several reports about other skin diseases causing anetoderma. A 16-year-old girl visited our clinic for the evaluation of asymptomatic atrophic macules on the head, upper trunk and lower extremities. She had a 10-month history of yellowish brown papules located on the same area fifteen years ago. Histopathologic findings at that time showed histiocytic infiltration with foam cells and Touton giant cells in the dermis, which were consistent with juvenile xanthogranuloma (JXG). Skin biopsy was carried out at an atrophic macule; histologic findings revealed a decrease in dermal elastic fibers. All these findings were compatible with anetoderma. To our knowledge, this case is the first report of anetoderma developed in JXG in Korea.
Acne Vulgaris ; Adolescent ; Anetoderma* ; Biopsy ; Chickenpox ; Dermis ; Elastic Tissue ; Female ; Foam Cells ; Giant Cells ; Head ; Humans ; Korea ; Lower Extremity ; Skin ; Skin Diseases ; Xanthogranuloma, Juvenile*

We report a case of pityriasis versicolor atrophicans in a 20-year-old woman who presented with chronic multiple brownish atrophic macules and patches on chest and back. The lesions had developed six years ago and the patient had used topical medication including steroid ointments for the last two years prior to visiting our clinic. KOH examination was positive, so skin biopsy was performed and the diagnosis of pityriasis versicolor atrophicans was made. Since our patient had applied topical steroids for some time, it was difficult to rule out steroid-induced atrophy in a common tinea versicolor. Also, differential diagnosis was performed with respect to other skin diseases manifesting with cutaneous atrophy including anetoderma.
Anetoderma ; Atrophy ; Biopsy ; Diagnosis, Differential ; Female ; Humans ; Ointments ; Pityriasis ; Skin ; Skin Diseases ; Steroids ; Thorax ; Tinea Versicolor ; Young Adult

Elastosis perforans serpiginosa (EPS) is a rare reactive perforating dermatosis that is characterized by the transepidermal elimination of abnormal elastic fibers. Penicillamine, which is one of the clear triggers for EPS, is a heavy metal chelator that is primarily used for disorders such as cystinuria and Wilson's disease. It may cause alterations in the dermal elastic tissue such as pseudo-pseudoxanthoma elasticum, acquired cutis laxa, EPS and anetoderma. Herein we present a case of cutis laxa and EPS in a 34-year-old man who was previously on a long-term, high-dose of penicillamine for Wilson's disease. The combination of EPS and cutis laxa induced by penicillamine has rarely been reported and we report the first such case in Korea.
Adult ; Anetoderma ; Cutis Laxa ; Cystinuria ; Elastic Tissue ; Hepatolenticular Degeneration ; Humans ; Korea ; Penicillamine ; Skin Diseases

Atrophic dermatofibrosarcoma protuberans (DFSP) is an uncommon clinical variant, which clinically mimics other atrophic dermatological conditions. Given the typical 'protuberant' morphology of DFSP, such atrophic lesions may be difficult to diagnose clinically. We report a 44-year-old man who presented with an 8-month history of an asymptomatic, depressed, anetoderma-like plaque on the right subclavicular area. He also presented with a 1-year history of a 1.5x1.5 cm, asymptomatic, firm, erythematous nodule above an atrophic lesion. Biopsy specimens were taken from each lesion. These specimens, along with histochemical staining for CD34, established the diagnosis of dermatofibrosarcoma protuberans.
Adult ; Anetoderma ; Biopsy ; Dermatofibrosarcoma ; Humans

Pilomatricoma, also known as the calcifying epithelioma of Malherbe, is a benign adnexal neoplasm that arises from primitive cells of the hair matrix. It usually appears as a firm, slowly growing dermal or subcutaneous nodule, almost solitary but occasionally multiple. Anetoderma is characterized clinically by discrete, atrophic skin lesions and pathologically by the focal loss of elastic fibers in the dermis. Anetodermic cutaneous changes in the skin overlying a pilomatricoma have been rarely described in the literature. Herein, we report 17-year-old girl who presented with two skin lesions, one of which was a painful nodule with bag-like, wrinkled surface on the left posterior shoulder and the other was asymptomatic deep seated nodule with skin colored surface on the left upper back. The histopathologic examination showed typical findings of pilomatricoma, and anetoderma was associated with tender nodule on the shoulder.
Adolescent ; Anetoderma* ; Dermis ; Elastic Tissue ; Female ; Hair ; Humans ; Pilomatrixoma* ; Shoulder ; Skin

Anetoderma is characterized by atrophic patches located mainly on the upper trunk. Secondary anetoderma occurs in the courses of various diseases, such as syphilis, lupus erythematosus, and leprosy. Among them secondary anetoderma due to pilomatricoma is rare and has a characteristic skin manifestation such as scrotal skin or round striae. Herein we report four cases of pilomatricomas with secondary anetodermic cutaneous changes. The overlying skin appeared variously as a pinkish, wrinkled, bag-like bulged, or scar-like atrophic surface. However the histopathologic examination showed commonly a prominent decrease of elastic fibers in the dermis overlying the pilomatricoma mass.
Anetoderma* ; Dermis ; Elastic Tissue ; Leprosy ; Pilomatrixoma* ; Skin ; Skin Manifestations ; Syphilis

Actinic granuloma (O'Brien) is an annular inflammatory reaction that develops in skin after long-term sun-exposure. Anetoderma is characterized by discrete skin lesions that appear to be loose and wrinkled. The primary type arises in clinically normal skin, and the secondary type appears in lesions of other disorders. We describe a case of anetoderma that developed on the neck, both arms and calves, and showed histopathological findings of actinic granuloma.
Actins* ; Anetoderma* ; Arm ; Granuloma ; Neck ; Skin