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Currently submitted to: JMIR Dermatology

Date Submitted: May 31, 2020
Open Peer Review Period: May 31, 2020 - Jul 26, 2020
(currently open for review)

Warning: This is an author submission that is not peer-reviewed or edited. Preprints - unless they show as "accepted" - should not be relied on to guide clinical practice or health-related behavior and should not be reported in news media as established information.

Pseudoxanthoma-like papillary dermal elastolysis: A case report

  • Jason Ho Seung Kim; 
  • Donald Jenkins Jr; 

ABSTRACT

An 88-year old female presented with axillary lesions on both sides that have developed over a year. She has been asymptomatic, but it was causing cosmetic concerns. There was no significant medical history and she was not taking any medications. Physical exam showed 1-6mm firm yellow dermal papules scattered over the axillae. Initial differential diagnoses included Fox-Fordyce disease and sebaceous cysts. First skin biopsy showed perivascular lymphocytes, extravasated red cells, and skin atrophy thought to be within the normal range expected of an elderly patient. There was some loss of elastic fibres within papillary dermis on Verhoeff-Van Gieson stain, but no clear diagnosis could be made. A second skin biopsy was performed which showed diminution of collagen fibres in reticular dermis and areas in papillary dermis lacking elastic fibres. Differential diagnoses were revised to include pseudoxanthoma-like papillary dermal elastolysis, but histopathology results were not definitive for the diagnosis. The diagnosis of pseudoxanthoma-like papillary dermal elastolysis was made based on the morphology and location of the lesions, epidemiological factors, and histopathological findings. No treatment was initiated, but the patient was content with knowing the diagnosis and agreed to vigilant monitoring of the lesions. This case discourages the sole reliance on histopathological evidence and reminds the importance of gathering clinical evidence to support the diagnosis of pseudoxanthoma-like papillary dermal elastolysis.


 Citation

Please cite as:

Kim JHS, Jenkins D Jr

Pseudoxanthoma-like papillary dermal elastolysis: A case report

JMIR Preprints. 31/05/2020:20884

DOI: 10.2196/preprints.20884

URL: https://preprints.jmir.org/preprint/20884

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