title: Dermoscopy and direct immunofluorescence findings of elastosis perforans serpiginosa.
abstract: Elastosis perforans serpiginosa (EPS) is a rare skin disorder characterized by transepidermal elimination of abnormal elastic fibres. We present a new case of D-penicillamine (DPA)-induced EPS, and describe the clinical, dermoscopic, histopathological and direct immunofluorescence (DIF) findings. A 33-year-old woman receiving treatment with DPA presented with annular skin lesions. Digital dermoscopy of the lesions showed a central area of pink and yellowish discolouration with keratotic papules in the periphery, surrounded by a white halo, disposed in a way that resembled the islands of an archipelago. Other lesions showed a white to yellow central colouration and 'chrysalides' surrounding the keratotic plugs. Linear and granular deposits of IgG attached to the abnormal elastic fibres were seen with DIF. Dermoscopy can be helpful in the diagnosis of EPS. Moreover, DIF findings in skin biopsies of this case support the immune-mediated pathogenesis of EPS.
authors.affiliation: Department of Dermatology, Fundación Jiménez Díaz, Universidad Autónoma, Madrid, Spain.
authors.forename: J L
authors.initials: JL
authors.lastname: Ramírez-Bellver
authors.affiliation: Department of Dermatology, Fundación Jiménez Díaz, Universidad Autónoma, Madrid, Spain.
authors.forename: C
authors.initials: C
authors.lastname: Bernárdez
authors.affiliation: Department of Dermatology, Fundación Jiménez Díaz, Universidad Autónoma, Madrid, Spain.
authors.forename: E
authors.initials: E
authors.lastname: Macías
authors.affiliation: Department of Dermatology, Fundación Jiménez Díaz, Universidad Autónoma, Madrid, Spain.
authors.forename: L
authors.initials: L
authors.lastname: Moya
authors.affiliation: Department of Dermatology, Fundación Jiménez Díaz, Universidad Autónoma, Madrid, Spain.
authors.forename: A M
authors.initials: AM
authors.lastname: Molina-Ruiz
authors.affiliation: Department of Pathology, Fundación Jiménez Díaz, Universidad Autónoma, Madrid, Spain.
authors.forename: P
authors.initials: P
authors.lastname: Cannata Ortiz
authors.affiliation: Department of Pathology, Fundación Jiménez Díaz, Universidad Autónoma, Madrid, Spain.
authors.forename: L
authors.initials: L
authors.lastname: Requena
mesh_terms: D000328:Adult; D002614:Chelating Agents / Q000009:adverse effects / Q000627:therapeutic use; D046169:Dermoscopy / Q000379:methods*; D004547:Elastic Tissue / Q000473:pathology; D005260:Female; D019085:Fluorescent Antibody Technique, Direct / Q000379:methods*; D006527:Hepatolenticular Degeneration / Q000150:complications / Q000188:drug therapy / Q000473:pathology; D006801:Humans; D010396:Penicillamine / Q000008:administration & dosage / Q000009:adverse effects* / Q000627:therapeutic use; D035583:Rare Diseases; D012867:Skin / Q000473:pathology; D012871:Skin Diseases / Q000139:chemically induced* / Q000473:pathology
chemical_list: D002614:Chelating Agents; D010396:Penicillamine