Primary anetoderma of Jadassohn-Pellizzari: A “saclike” skin
A 37-year-old man presented with history of skin lesions on the trunk and face of one-year duration. On examination, multiple asymptomatic oval outpouchings, with a “saclike” appearance, were noted on his back. The lesions effortlessly herniated inward with finger-tip pressure, producing a buttonhole sign [Figure 1]. Inflammatory nodules were observed on his face. Antiphospholipid antibodies, antinuclear antibody and serologic tests for syphilis were negative. Histopathology revealed mild perivascular lymphocytic infiltrates in the upper-to-mid dermis. Verhoeff-Van Gieson staining of lesional skin showed a significant reduction of elastic fibers within the dermis, compared with peripheral healthy skin. The patient was diagnosed as primary anetoderma of Jadassohn-Pellizzari.