• Users Online: 1870
  • Print this page
  • Email this page


 
  Table of Contents  
THROUGH THE LENS
Year : 2014  |  Volume : 5  |  Issue : 2  |  Page : 236-237  

Elastosis perforans serpiginosa


1 Department of Dermatology, General Polyclinic of Rio de Janeiro, Rio de Janeiro, Brazil
2 The Brazilian Society of Dermatology, Universidade Federal Fluminense, Division of Dermatopathology, Universidade Federal Fluminense, Niterói, Brazil
3 Department of Pathology, Universidade Federal Fluminense, Division of Dermatopathology, Universidade Federal Fluminense, Niterói, Brazil
4 Department of Medical Specialties, School of Medicine and Surgery, Federal University of Rio de Janeiro State, General Polyclinic of Rio de Janeiro, Rio de Janeiro, Brazil

Date of Web Publication21-Apr-2014

Correspondence Address:
Ludimila Noleto de Rezende
Rua da Passagem, 101/304 A, Botafogo, Rio de Janeiro - RJ, CEP: 22290-030
Brazil
Login to access the Email id

Source of Support: None, Conflict of Interest: None


DOI: 10.4103/2229-5178.131156

Rights and Permissions

How to cite this article:
de Rezende LN, Nuñez MG, Clavery TG, Constancio EG, Rochael MC, Pires GT, Lupi O. Elastosis perforans serpiginosa. Indian Dermatol Online J 2014;5:236-7

How to cite this URL:
de Rezende LN, Nuñez MG, Clavery TG, Constancio EG, Rochael MC, Pires GT, Lupi O. Elastosis perforans serpiginosa. Indian Dermatol Online J [serial online] 2014 [cited 2020 Apr 5];5:236-7. Available from: http://www.idoj.in/text.asp?2014/5/2/236/131156

A 22-year-old male patient, African descent, in august 2011, complained of "dots in his arms," for one year duration, associated with slight pruritus. The patient had obesity level II and high blood pressure, on regular hydrochlorothiazide and losartan.

On clinical examination, erythematous papules with central crusts, coalescing to form serpiginous lesions were seen over arms, [Figure 1] and [Figure 2]. It was suggestive of elastosis perforans serpiginosa (EPS) and a biopsy was carried out in the right arm lesions.
Figure 1: Erythematous papules with central crusts, coalescing to form serpiginous lesions over right arm

Click here to view
Figure 2: Close up view of the right arm

Click here to view


Histopathological examination of the material, subjected to special Weigert staining, showed fragmented elastic fibers in the base of the perforation, with less intense staining of epidermal depression [Figure 3] and [Figure 4]. Therefore, the diagnosis was confirmed.
Figure 3: fragmented elastic fibers in the base of the perforation

Click here to view
Figure 4: less intense staining of epidermal depression

Click here to view


EPS is a rare skin condition included among the primary perforating dermatoses of dermal origin characterized by the transepidermal extrusion of elastic fibers. The etiopathogenesis may be considered idiopathic or associated with Down's syndrome, hereditary diseases of the connective tissue, and the use of D-penicillamine. [1] EPS should be suspected in a patient presenting with keratotic papules, asymptomatic or pruriginous plaques grouped in an arciform or serpiginous pattern. The diagnosis is confirmed by histopathology (gold standard). Clinically, the differential diagnoses are granuloma annulare, tinea corporis, annular sarcoidosis, cutaneous calcinosis, and porokeratosis of Mibelli. The treatment options explored in published articles were cryotherapy, topical tretinoin, 0.1% tazarotene gel, oral isotretinoin, imiquimod, carbon dioxide laser (CO 2 laser) and pulsed dye laser, all these results with some constant, varying greatly between authors. [2],[3],[4]

In this case, patient was given the option of treatment with CO 2 laser and cryotherapy. The patient opted for cryotherapy and after the first session, the lesions showed partial improvement, with mild hypochromia in some larger lesions.

 
   References Top

1.Atzori L, Pinna AL, Pau M, Aste N. D-penicillamine elastosis perforans serpiginosa: Description of two cases and review of the literature. Dermatol Online J 2011;17:3.  Back to cited text no. 1
    
2.Kaufman AJ. Treatment of elastosis perforans serpiginosa with the flashlamp pulsed dye laser. Dermatol Surg 2000;26:1060-2.  Back to cited text no. 2
[PUBMED]    
3.Ratnavel RC, Norris PG. Penicillamine-induced elastosis perforans serpiginosa treated successfully with isotretinoin. Dermatology 1994;189:81-3.  Back to cited text no. 3
    
4.Tuyp EJ, McLeod WA. Elastosis perforans serpiginosa: Treatment with liquid nitrogen. Int J Dermatol 1990;29:655-6.  Back to cited text no. 4
    


    Figures

  [Figure 1], [Figure 2], [Figure 3], [Figure 4]


This article has been cited by
1 Enfermedades adquiridas del tejido elástico
F. Stephan,R. Haber
EMC - Dermatología. 2017; 51(3): 1
[Pubmed] | [DOI]
2 Acquired reactive perforating collagenosis
Chengwen Fei,Yao Wang,Yu Gong,Hui Xu,Qian Yu,Yuling Shi
Medicine. 2016; 95(30): e4305
[Pubmed] | [DOI]



 

Top
 
 
  Search
 
    Similar in PUBMED
   Search Pubmed for
   Search in Google Scholar for
    Access Statistics
    Email Alert *
    Add to My List *
* Registration required (free)  

 
  In this article
    References
    Article Figures

 Article Access Statistics
    Viewed953    
    Printed15    
    Emailed0    
    PDF Downloaded214    
    Comments [Add]    
    Cited by others 2    

Recommend this journal