The spectrum of fibroelastolytic papulosis: a retrospective case series.
Introduction: There is an overlap between clinical and pathological features of the entities known as pseudoxanthoma elasticum-like papillary dermal elastolysis (PXE-PDE) and white fibrous papulosis of the neck (WFPN). Although the term fibroelastolytic papulosis has been used to encompass both entities as spectrum variants of a one and only disease, many authors still differentiate the two.
Methods: Cases of fibroelastolytic papulosis confirmed by histopathologic examination were retrospectively reviewed within a time frame of 2.5 years.
Results: Five cases of fibroelastolytic papulosis were identified. All patients were females aged between 63 and 78 years, presenting with an asymptomatic eruption of isolated or coalescing white to yellow papules on the neck. Two of the patients also had involvement of other anatomical areas. In all cases histology demonstrated a significantly decreased or absent papillary dermal elastic plexus, a mild superficial perivascular lymphocytic infiltrate and sparse melanophages in the papillary dermis, without interface changes. A decrease in upper reticular dermal elastic fibers was noted in four cases and thickening of dermal collagen bundles in three cases. Dilated superficial dermal vessels were present in 3 cases and mild epidermal atrophy in one case.
Conclusion: We find the differentiation of PXE-PDE and WFPN to be somewhat theoretical, often confusing, and based on non-significant subtle histological and clinical differences. In our opinion, we should not continue to use these terms, but favor the common term of fibroelastolytic papulosis.
Shimizu H, Kimura S, Harada T, Nishikawa T. White fibrous papulosis of the neck: A new clinicopathologic entity? J Am Acad Dermatol. 1989;20:1073–7.
Rongioletti F, Rebora A. Pseudoxanthoma elasticum-like papillary dermal elastolysis. J Am Acad Dermatol. 1992;26:648–50.
Lewis KG, Bercovitch L, Dill SW, Robinson-Bostom L. Acquired disorders of elastic tissue: Part II. decreased elastic tissue. J Am Acad Dermatol. 2004;51:165–85.
Balus L, Amantea A, Donati P, Fazio M, Giuliano MC, Bellocci M. Fibroelastolytic papulosis of the neck: a report of 20 cases. Br J Dermatol. 1997;137:461–6.
Jagdeo J, Ng C, Ronchetti IP, Wilkel C, Bercovitch L, Robinson-Bostom L. Fibroelastolytic papulosis. J Am Acad Dermatol. 2004;51:958–64.
Patterson AT, Beasley KJ, Kobayashi TT. Fibroelastolytic papulosis: histopathologic confirmation of disease spectrum variants in a single case. J Cutan Pathol. 2016;43:142–7.
Rongioletti F, Rebora A. Fibroelastolytic patterns of intrinsic skin aging: pseudoxanthoma-elasticum-like papillary dermal elastolysis and white fibrous papulosis of the neck. Dermatology. 1995;191:19–24.
Rongioletti F, Izakovic J, Romanelli P, Lanuti E, Miteva M. Pseudoxanthoma elasticum-like papillary dermal elastolysis: A large case series with clinicopathological correlation. J Am Acad Dermatol. 2012;67:128–35.
Castilla C, Kim RH, Meehan SA, Pomerantz R. White fibrous papulosis of the neck. Dermatol Online J.
Kandhari R, Kandhari S, Jain S. White fibrous papulosis of the neck. Indian J Dermatol Venereol Leprol. 2015;81:224.
Vázquez-Osorio I, Rosón E, Suárez-Peñaranda JM, Vázquez-Veiga H. Pseudoxanthoma elasticum-like papillary dermal elastolysis. Actas Dermosifiliogr. 2015;106:333–6.
Zanca A, Contri MB, Carnevali C, Bertazzoni MG. White fibrous papulosis of the neck. Int J Dermatol. 1996;35:720–2.
Siragusa M, Batolo D, Schepis C. White fibrous papulosis of the neck in three Sicilian patients. Australas J Dermatol. 1996;37:202–4.
Wang D, Zhu W. White fibrous papulosis of the neck: a chinese case. J Dermatol. 2005;32:497–9.
Byun JY, Do MO, Kim SH, Choi HY, Myung KB, Choi YW. Pseudoxanthoma elasticum-like papillary dermal elastolysis developed in early middle age. J Dermatol. 2007;34:709–11.
Minagawa A, Koga H, Saida T. Dermoscopy of white fibrous papulosis of the neck. Arch Dermatol.
Moreira AP, de Souza AL, Quevedo Filho LP, Rochael MC, Amaral V. White fibrous papulosis of the neck: the first South American case. Dermatol Online J. 2009;15:9.
Mitoma C, Takahara M, Takeshita T, Kiryu H, Moroi Y, Furue M. White fibrous papulosis on the trunk and upper arms. Int J Dermatol. 2013;52:337–8.
Schaffer PR, Tran K, Kaplan J, Patel R, Kamino H, Ramachandran S, et al. White fibrous papulosis of the neck. Dermatol Online J. 2014;20.
Gencoglan G, Ceylan C, Kazandi AC. White fibrous papulosis of the neck. Cutan Ocul Toxicol. 2011;30:69–71.
Lueangarun S, Panchaprateep R. White fibrous papulosis of the neck treated with fractionated 1550-nm erbium glass laser: a case report. J Lasers Med Sci. 2016;7:256–8.
Pitarch G, Torrijos A, García-Melgares ML, Roche E, Calatayud A, Fortea JM. Elastolisis dérmica papilar similar a pseudoxantoma elástico. Actas Dermosifiliogr. 2006;97:131–3.
Lopes L, Reis M, Gouveia A, Vasconcelos J, Soares-Almeida L, Filipe PL. Elastólise da derme papilar semelhante a Pseudoxantoma Elástico - Uma entidade sub-diagnosticada. Rev Soc Port Dermatol Venereol. 2014;72:223–6.
Gambichler T, Reininghhaus L, Schaller J. Early-onset pseudoxanthoma elasticum-like papillary dermal elastolysis. J Eur Acad Dermatology Venereol. 2016;30:448–9.
Valbuena V, Assaad D, Yeung J. Pseudoxanthoma elasticum–like papillary dermal elastolysis: a single case report. J Cutan Med Surg. 2017;21:345–7.
Foering K, Torbeck RL, Frank MP, Saedi N. Treatment of Pseudoxanthoma elasticum-like papillary dermal elastolysis with non-ablative fractional resurfacing laser resulting in clinical and histologic improvement in elastin and collagen. J Cosmet Laser Ther. 2017 (in press). doi: 10.1080/14764172.2017.1358457
Fukuda H, Mukai H, Otani A, Oharaseki T, Takahashi M. Dermoscopic findings of pseudoxanthoma elasticum-like papillary dermal elastolysis. Eur J Dermatol. 2017;27:99–100.
Alves R, Ferreira L, Vale E, Bordalo O. Pseudoxanthoma elasticum papillary dermal elastolysis: A case report. Dermatol Res Pract. 2010;2010:4–7.
Song YC, Oh BH, Ko JH, Kim JY, Hwang YJ, Won Lee Y, et al. A case of fibroelastolytic papulosis on the neck of a young man. Ann Dermatol. 2011;23:193–7.
Chong SP, Woodley DT, Kim GH, Shim EK. Treatment of fibroelastolytic papulosis with fractionated carbon dioxide laser. J Cosmet Laser Ther. 2015;17:90–2.
Oiso N, Kato M, Kawada A. Fibroelastolytic papulosis in an elderly woman with a 30-year history: Overlapping between pseudoxanthoma elasticum-like papillary dermal elastolysis and white fibrous papulosis of the neck. Eur J Dermatology. 2014;24:688–9.
Maione V, Errichetti E, Stinco G, Orsaria M, Patrone P. Fibroelastolytic papulosis of the neck treated with topical tretinoin. J Dermatol. 2014;41:758–9.
Ho D, Jagdeo J. Fractionated carbon dioxide laser treatment of fibroelastolytic papulosis with excellent cosmetic result and resolution of pruritus. J Drugs Dermatol. 2015;14:1354–7.
Wang AR, Lewis K, Lewis M, Robinson-Bostom L. Papillary dermal elastosis: A unique elastic tissue disorder or an unusual manifestation of pseudoxanthoma elasticum-like papillary dermal elastolysis? J Cutan Pathol. 2009;36:1010–3.
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