Dermatology Online Journal

Linear focal elastosis
Martha P. Arroyo and Nicholas A. Soter
Dermatology Online Journal 7(2): 18

New York University Department of Dermatology

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History

This 83-year-old man has a one-year history of lesions on his back. They are asymptomatic without pain or pruritus. He denies any other lesions. Past medical history includes prostate cancer.

Physical Examination

Figure 1	Figure 2

Yellow and erythematous linear plaques were present on the back.

Histopathology

There are coarsely clumped elastic fibers in the reticular dermis, which is highlighted by an elastic tissue stain. Also present was a sparse, superficial, perivascular infiltrate of small lymphocytes.

Comment

Linear focal elastosis is an uncommon dermal elastosis, with 14 cases documented to date. It was first described by Burket JM, et al in 1989 in three white men with onset after age 60. However, recent case reports have identified linear focal elastosis in both young men and women of diverse ethnic backgrounds. There is no history of trauma.

Clinically, it presents as asymptomatic lesions that are often noted incidentally. It appears as layered, symmetric, palpable, striae-like, yellow bands of the middle and lower back that extend horizontally and on both sides of the vertebral column. Histologically, deposition of abundant pale-staining material separating collagen bundles is noted. Elastic tissue stain shows that material to be agglutinated elastic tissue and von Kossa's stain is negative. Electron photomicrographs show bits of fragmented elastic fibers.

The pathogenesis is unknown. Some authors have postulated that linear focal elastosis may represent hyperplasia of elastic fibers in response to damage, primarily in the setting of concomitant striae distensae. Others have postulated that it may represent a nevoid or hamartomatus condition in which degenerative and regenerative processes are occurring in elastic fibers.

References

Burket JM, et al. Linear focal elastosis (elastotic striae). J Am Acad Dermatol 20:633, 1989

Moiin A, et al. Linear focal elastosis in a young black man: a new presentation. J Am Acad Dermatol 30:874, 1994

Tamada Y, et al. Linear focal elastosis: a review of three cases in young Japanese men. J Am Acad Dermatol 36:301, 1997

Hashimoto K. Linear focal elastosis: keloidal repair of striae distensae. J Am Acad Dermatol 39:309, 1998

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