Yellowish-white papules in a cobblestone pattern on the neck
2 Department of Histopathology, Hospital Universitario Infanta Leonor, Madrid, Spain
Department of Dermatology, Hospital Universitario Infanta Leonor, Madrid
|How to cite this article:
Conde-Montero E, Chavarría Mur E, Rivera García T, de la Cueva Dobao P. Yellowish-white papules in a cobblestone pattern on the neck. Indian J Dermatol Venereol Leprol 2016;82:464-466
A 65-year-old woman with an unremarkable medical history was referred to our department with a 2-year history of multiple pruritic lesions on the lateral and posterior parts of her neck. She denied any history of preceding trauma or prolonged sun exposure at the affected sites. None of her family members had similar skin lesions. She had no history of renal disease or intake of drugs like D-penicillamine. Physical examination revealed multiple, yellowish-white, 2 mm, non-follicular papules coalescing to form cobblestone-like plaques on her neck [Figure - 1]. No other sites were involved. A representative lesion was biopsied and no histological abnormalities were found with routine hematoxilyn-eosin staining [Figure - 2]. Special staining with acid orcein demonstrated loss of elastic tissue in the papillary dermis and an anomalous distribution and morphology of elastic fibers in the reticular dermis [Figure - 3]. Blood tests, cardiovascular and ophthalmological examinations were completely normal.
|Figure 1: Multiple yellowish-white non-follicular papules forming cobblestone-like plaques on the neck|
|Figure 2: Panoramic view showing apparently normal skin (H and E ×20)|
|Figure 3: Orcein stain reveals loss of elastic tissue in the papillary dermis with an anomalous distribution and morphology of elastic fibers in the reticular dermis (×400)|
What is your Diagnosis?
Rongioletti F, Rebora A. Pseudoxanthoma elasticum-like papillary dermal elastolysis. J Am Acad Dermatol 1992;26:648-50.[Google Scholar]
Vázquez-Osorio I, Rosón E, Suárez-Peñaranda JM, Vázquez-Veiga H. Pseudoxanthoma elasticum-like papillary dermal elastolysis. Actas Dermosifiliogr 2015;106:333-6.[Google Scholar]
Rongioletti F, Izakovic J, Romanelli P, Lanuti E, Miteva M. Pseudoxanthoma elasticum-like papillary dermal elastolysis: A large case series with clinicopathological correlation. J Am Acad Dermatol 2012;67:128-35.[Google Scholar]
Revelles JM, Machan S, Pielasinski U, Camacho D, Vallés L, Santonja C, et al. Pseudoxanthoma elasticum-like papillary dermal elastolysis: Immunohistochemical study using elastic fiber cross-reactivity with an antibody against amyloid P component. Am J Dermatopathol 2012;34:637-43.[Google Scholar]