11 - 70 - ANETODERMA

Question 1

key defect in anetoderma

Answer 1

damage to the dermal elastic fibers

Question 2

anetoderma can be associated with various systemic conditions, primarily what syndrome?

Answer 2

antiphospholipid syndrome

Question 3

All types of anetoderma are characterized by what?

Answer 3

circumscribed loss of normal skin elasticity

Question 4

The most common sites of anetoderma

Answer 4

chest, back, neck, and upper extremities

Question 5

occurs when there is no underlying associated skin disease (ie, it arises on clinically normal skin)

Answer 5

Primary anetoderma

Question 6

primary anetoderma with preceding inflammatory lesions, mainly erythema

Answer 6

Jadassohn-Pellizzari type

Question 7

primary anetoderma without preceding inflammatory lesions

Answer 7

Schweninger-Buzzi type

Question 8

implies that the characteristic atrophic lesion has appeared in the exact same site as a previous specific pathology

Answer 8

secondary anetoderma

Question 9

most common causes of secondary anetoderma

Answer 9

acne and varicella

Question 10

Both primary and secondary types of anetoderma may be associated with an underlying disease. What are these conditions?

Answer 10

• Antiphospholipid syndrome
• Autoimmune thyroiditis
• HIV

Question 11

Infectious causes of secondary anetoderma

Answer 11

“SMoLL”

• Syphilis
• Molluscum contagiosum
• Lyme disease
• Leprosy

Question 12

Inflammatory causes of secondary anetoderma

Answer 12

“GranD LiSa”

• Granuloma annulare
• Discoid lupus erythematosus
• Lichen planus
• Sarcoidosis

Question 13

Tumoral causes of secondary anetoderma

Answer 13

“JuCIPiX”

• Juvenile xanthogranuloma
• Cutaneous B-cell lymphoma
• Involuted infantile hemangiomas
• Pilomatricomas
• Xanthomas

Question 14

predominant defect of anetoderma in histopath

Answer 14

focal partial or complete loss of elastic tissue in the papillary and/or midreticular dermis

• There are usually some residual abnormal, irregular, and fragmented elastic fibers
• Presumably, the weakening of the elastic network leads to flaccidity and herniation.

Question 15

has been postulated to be a major contributing factor in the degeneration of elastic fibers in middermal elastolysis

Answer 15

Ultraviolet exposure

including natural sunlight and narrowband ultraviolet B phototherapy

Question 15

rare acquired disorder of elastic tissue. It is characterized by patches and plaques of diffuse, fine, wrinkled skin, most often located on the trunk, neck, and arms.

Answer 15

MIDDERMAL ELASTOLYSIS

Question 16

Identify the type of MDE

asymptomatic, well-demarcated, or diffuse areas of fine wrinkling usually in a symmetric distribution

Answer 16

Type I

Question 17

Identify the type of MDE

Discrete perifollicular papules leaving the hair follicle itself as an indented center

Answer 17

Type II

Question 18

Identify the type of MDE

reticular pattern with erythematous patches and telangiectasia

Answer 18

Type III

Question 19

areas of predilection of MDE

Answer 19

trunk, neck, and upper extremities

Question 20

histopath findings of MDE

Answer 20

The characteristic features are seen on elastic tissue stains (such as Verhoeff-van Gieson or Weigert) and reveal a selective band-like loss of elastic fibers in the middermis

Macrophagic elastophagocytosis can occasionally be seen

There is preservation of normal elastic tissue in the superficial papillary dermis above, in the reticular dermis below, and along adjacent hair follicles.

Question 21

differs by a selective and almost complete loss of elastic fibers surrounding hair follicles compared with preservation of elastic fibers around follicles in MDE

Answer 21

Perifollicular elastolysis

Question 22

etiolofy of Perifollicular elastolysis

Answer 22

Elastase-producing Staphylococcus epidermidis was found in the hair follicles and is the presumed etiology of this condition.

Question 23

MC sites of striae in girls

Answer 23

breasts, thighs, hips, and buttocks

Question 24

MC sites of striae in boys

Answer 24

shoulders, lumbosacral region, and thighs

Question 25

form of dermal atrophy that presents as 1 or several sharply demarcated depressed patches with no outpouching, usually on the back of adolescents or young adults

Answer 25

Idiopathic atrophoderma of Pasini and Pierini ## Footnote The lesions are well-demarcated depressed patches, usually occurring on the trunk, especially on the back and lumbosacral region, followed in frequency by the chest, arms, and abdomen. The distribution is often symmetric and bilateral.

Question 26

antibodies to what bacteria have been reported in Idiopathic atrophoderma of Pasini and Pierini?

Answer 26

Borrelia burgdorferi

Question 27

The borders or edges of these lesions are sharply defined, and they are usually described as abrupt, “cliff-drop” borders ranging from 1 to 8 mm in depth, although they can have a gradual slant.

Answer 27

Idiopathic atrophoderma of Pasini and Pierini ## Footnote These depressed patches are characteristic and give the impression of inverted plateaus, or, if multiple lesions are present, they can have the appearance of Swiss cheese.

Question 28

usually present as indurated, often hyperpigmented plaques with a characteristic **peripheral lilac rim**

Answer 28

morphea

Question 29

term of follicular atrophoderma that applies when the lesions are found exclusively on the **cheeks**

Answer 29

ATROPHODERMA VERMICULATUM ## Footnote Multiple inflammatory symmetric papules on the cheeks, presumably centered around hair follicles, may precede the atrophic lesions. These papules then go on to develop pitted, atrophic, and depressed scars in a reticulated or honeycomb pattern

Question 30

differs from atrophoderma vermiculatum by affecting primarily the lateral portion of the eyebrows (ophryogenes) with erythema, follicular papules, and alopecia

Answer 30

Ulerythema ophryogenes (or keratosis pilaris atrophicans faciei)

Question 31

characterized by follicular atrophoderma, milia, multiple basal cell carcinomas, hypotrichosis, and localized hypohidrosis

Answer 31

Bazex-Dupré-Christol syndrome