title: Perforating pseudoxanthoma elasticum with secondary elastosis perforans serpiginosa-like changes: dermoscopy, confocal microscopy and histopathological correlation.
abstract: Pseudoxanthoma elasticum is a rare congenital inherited elastolytic disorder that has sometimes been observed in association with transepidermal elimination of altered and calcified elastic fibers resulting in elastosis perforans serpiginosa-like changes. In this case, histopathology is usually performed to rule out other conditions. The case of a 38-year-old woman with two slowly enlarging asymptomatic plaques occurring on the neck and surrounded by coalescing yellowish papules with a typical cobblestone appearance, evaluated by polarized light dermoscopy and reflectance confocal microscopy with histopathologic correlations, is described. Noteworthy, with reflectance confocal microscopy, the transepidermal elimination of the altered elastic fibers in the plaques was detected as hyperreflective material filling the dermal papillae, whereas the transversal cleavage of the calcified elastic fibers yielded a peculiar 'eggs-in-the-basket' feature.
authors.affiliation: Dermatology Clinic, University of Catania, Catania, Italy.
authors.forename: Maria Rita
authors.initials: MR
authors.lastname: Nasca
authors.affiliation: Dermatology Clinic, University of Catania, Catania, Italy.
authors.forename: Francesco
authors.initials: F
authors.lastname: Lacarrubba
authors.affiliation: Department "G.F. Ingrassia", Section of Anatomic Pathology, University of Catania, Catania, Italy.
authors.forename: Rosario
authors.initials: R
authors.lastname: Caltabiano
authors.affiliation: Dermatology Clinic, University of Catania, Catania, Italy.
authors.forename: Anna Elisa
authors.initials: AE
authors.lastname: Verzì
authors.affiliation: Dermatology Clinic, University of Catania, Catania, Italy. cldermct@gmail.com.
authors.forename: Giuseppe
authors.initials: G
authors.lastname: Micali
mesh_terms: D000328:Adult; D005260:Female; D006801:Humans; D018613:Microscopy, Confocal; D008857:Microscopy, Interference; D009333:Neck / Q000473:pathology*; D011561:Pseudoxanthoma Elasticum / Q000175:diagnosis*; D012871:Skin Diseases / Q000175:diagnosis*
keywords: confocal microscopy; connective tissue disorders; dermoscopy; elastic fibers; elastosis perforans serpiginosa