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2002:68:2;98-99
PMID: 17656892

Eruptive collagenoma

Sanjay V Mukhi, Pramod Kumar, D Yuvarajkumar, CV Raghuveer
 Department of Dermatology and Pathology, Kasturba Medical College, Mangalore - 575 001, India

Correspondence Address:
Pramod Kumar
Department of Dermatology, KMC, Attavar Hospital, Mangalore
India
How to cite this article:
Mukhi SV, Kumar P, Yuvarajkumar D, Raghuveer C V. Eruptive collagenoma. Indian J Dermatol Venereol Leprol 2002;68:98-99
Copyright: (C)2002 Indian Journal of Dermatology, Venereology, and Leprology

Abstract

A case of eruptive collagenoma in a male is being reported. He presented with asymptomatic nodules and plaques over the trunk, upper extremity and face of 15 years duration. Family history was negative. Histopathology with H & E stain followed by Verhoeff van Gieson s staining revealed increased collagen in dermis confirming the diagnosis of eruptive collagenoma. Patient also had Beckers naevus.
Keywords: Eruptive collagenoma, Beckers noevus

Introduction

Connective tissue naevi are defind as hamartomas of dermal connective tissue components. Uitto et al have classified them according to the predominant element of extra cellular connective tissue, such as collagen, elastic fibres or proteoglycan and according to the inheritance pattern.[1] Connective tissue naevi in which collagen dominates are referred to as the Lipschutz type,while those in which elastic tissue changes are predominant are known as the Lewandowsky type.[2]

The hereditary types of connective tissue naevi include dermatofibrosis ventriculares disseminata in the Buschke Ollendroff syndrome, familial cutaneous collagenoma and shagreen patches in tuberous sclerosis.[3]

Case Report

A 42-year-old man presented with asymptomatic sudden eruption of skin-coloured nodules and plaques over back, abdomen, upper limb and face since 15 years. There was no history of trauma or syphilis in the past.

Examination revealed multiple skincoloured, firm non-tender nodules and plaques of variable sizes on back, abdomen, upper limb and face. Peau ′d orange appearance was noted in some nodules on pinching. Patient also had Beckers naevus present over the left side of chest.

Routine investigations were within normal limits. Blood VDRL was non reactive. X-ray of the pelvis was normal. Histopathology showed lobules of densely collagenized acellular connective tissue in the dermis insinuating between the dermal appendages and extending deeper towards the subcutis. The overlying epidermis was flattened at places due to the collagen pushing it up and acanthotic at others.Verhoeff Van Geison′s stain revealed marked reduction of elastic tissue and confirmed that the lobules of connective tissue were nothing but collagen. [Figure - 1]

Discussion

Eruptive collagenomas are acquired type of connective tissue naevi of collagen type and are referred to as Lipschutz type.[4] The dermal nodules seen in eruptive collagenoma are discrete, firm, skin - coloured, and slightly elevated. Some lesions have a Peau ′d orange surface. Lesions are symmetrically distributed over trunk and upper parts of arms.[5]

It differs from familial cutaneous collagenoma by absence of family history and from Buschke- Ollendroff syndrome by absence of osteopoikilosis;a benign disease of bone characterised by circumscribed areas of increased bone density especially in long and flat bone.

Becker′s neavus have been reported to be associated with connective tissue neavi.[6] The case reported here has clinical and histopathological features of eruptive collagenoma with involvement of face (which is not reported) and associated with Beckers naevus.

References
1.
Ditto J, Santa - Cruz DJ, Eisen AZ. Connective tissue naevi of the skin. J Am Acad Dermatol 1980;3:441-461.
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2.
Rocha G, Winkelmann RK. Connective tissue naevus. Arch Dermatol 1962;85:722-729.
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3.
Arnold HL, Oldom RB, James WD. Andrew's Diseases of the Skin, 8th edn. WB Sounder's Company, Philadelphia 1990;714-715.
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4.
Berberian BB, Wood C. Asymptomatic nodules on the back and abdomen. Arch Dermatol 1987;123:811.
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Henderson RR, Wheeler CE, Abele DC. Familial cutaneous collagenoma. Arch Dermatol 1968;98:23-27.
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Valia RG, Jerajani HR, Amladi ST. Naevi and other developmental defects. In: Textbook and Atlas of Dermatology vol I, edited by Valia RG, Valia AR, Bhalani Publishing House, Bombay, 1st edition 119.
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