11 - 70 - ANETODERMA Flashcards
key defect in anetoderma
damage to the dermal elastic fibers
anetoderma can be associated with various systemic conditions, primarily what syndrome?
antiphospholipid syndrome
All types of anetoderma are characterized by what?
circumscribed loss of normal skin elasticity
The most common sites of anetoderma
chest, back, neck, and upper extremities
occurs when there is no underlying associated skin disease (ie, it arises on clinically normal skin)
Primary anetoderma
primary anetoderma with preceding inflammatory lesions, mainly erythema
Jadassohn-Pellizzari type
primary anetoderma without preceding inflammatory lesions
Schweninger-Buzzi type
implies that the characteristic atrophic lesion has appeared in the exact same site as a previous specific pathology
secondary anetoderma
most common causes of secondary anetoderma
acne and varicella
Both primary and secondary types of anetoderma may be associated with an underlying disease. What are these conditions?
- Antiphospholipid syndrome
- Autoimmune thyroiditis
- HIV
Infectious causes of secondary anetoderma
“SMoLL”
- Syphilis
- Molluscum contagiosum
- Lyme disease
- Leprosy
Inflammatory causes of secondary anetoderma
“GranD LiSa”
- Granuloma annulare
- Discoid lupus erythematosus
- Lichen planus
- Sarcoidosis
Tumoral causes of secondary anetoderma
“JuCIPiX”
- Juvenile xanthogranuloma
- Cutaneous B-cell lymphoma
- Involuted infantile hemangiomas
- Pilomatricomas
- Xanthomas
predominant defect of anetoderma in histopath
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.
has been postulated to be a major contributing factor in the degeneration of elastic fibers in middermal elastolysis
Ultraviolet exposure
including natural sunlight and narrowband ultraviolet B phototherapy
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.
MIDDERMAL ELASTOLYSIS
Identify the type of MDE
asymptomatic, well-demarcated, or diffuse areas of fine wrinkling usually in a symmetric distribution
Type I
Identify the type of MDE
Discrete perifollicular papules leaving the hair follicle itself as an indented center
Type II
Identify the type of MDE
reticular pattern with erythematous patches and telangiectasia
Type III
areas of predilection of MDE
trunk, neck, and upper extremities
histopath findings of MDE
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.
differs by a selective and almost complete loss of elastic fibers surrounding hair follicles compared with preservation of elastic fibers around follicles in MDE
Perifollicular elastolysis
etiolofy of Perifollicular elastolysis
Elastase-producing Staphylococcus epidermidis was found in the hair follicles and is the presumed etiology of this condition.
MC sites of striae in girls
breasts, thighs, hips, and buttocks
MC sites of striae in boys
shoulders, lumbosacral region, and thighs
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
Idiopathic atrophoderma of Pasini and Pierini
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.
antibodies to what bacteria have been reported in Idiopathic atrophoderma of Pasini and Pierini?
Borrelia burgdorferi
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.
Idiopathic atrophoderma of Pasini and Pierini
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.
usually present as indurated, often hyperpigmented plaques with a characteristic peripheral lilac rim
morphea
term of follicular atrophoderma that applies when the lesions are found exclusively on the cheeks
ATROPHODERMA VERMICULATUM
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
differs from atrophoderma vermiculatum by affecting primarily the lateral portion of the eyebrows (ophryogenes) with erythema, follicular papules, and alopecia
Ulerythema ophryogenes (or keratosis pilaris atrophicans faciei)
characterized by follicular atrophoderma, milia, multiple basal cell carcinomas, hypotrichosis, and localized hypohidrosis
Bazex-Dupré-Christol syndrome
