title: Unknown: Papules on the knees. Elastosis perforans serpiginosa (EPS).
abstract: Elastosis perforans serpiginosa (EPS) can occur in patients with an underlying connective tissue disorder. Down syndrome, osteogenesis imperfecta, acrogeria, Ehlers-Danlos syndrome type IV, Marfan syndrome, pseudoxanthoma elasticum, Rothmund-Thomson syndrome, and scleroderma have all been associated with EPS. The clinical appearance exhibits umbilicated papules arranged in a typical serpiginous pattern, usually located around the neck. Less frequently, lesions may be seen on the face, abdomen, and extremities with a symmetrical distribution, as in our case. The clinical course may be variable with a spontaneous resolution in a few months or years, but frequently new lesions develop leading to persistence and progression of the disorder. We describe a 12-year-old girl affected by Down syndrome who presented a localized form of EPS, which involved only the extremities. Strangely, it resolved spontaneously after biopsy with no recurrence, without therapy.
authors.affiliation: Unit of Dermatology, Dept. of Surgical Sciences, Parma University Hospital, Parma, Italy. valeria.boccaletti@gmail.com
authors.forename: Valeria P
authors.initials: VP
authors.lastname: Boccaletti
authors.forename: Roberto
authors.initials: R
authors.lastname: Ricci
authors.forename: Giuseppe
authors.initials: G
authors.lastname: De Panfilis
mesh_terms: D002648:Child; D004314:Down Syndrome / Q000150:complications*; D005260:Female; D019382:Human Growth Hormone / Q000627:therapeutic use; D006801:Humans; D007018:Hypopituitarism / Q000150:complications / Q000188:drug therapy; D007037:Hypothyroidism / Q000150:complications / Q000188:drug therapy; D007717:Knee; D012075:Remission, Spontaneous; D012871:Skin Diseases / Q000175:diagnosis* / Q000209:etiology / Q000473:pathology; D013974:Thyroxine / Q000627:therapeutic use
chemical_list: D019382:Human Growth Hormone; D013974:Thyroxine