Mid dermal elastolysis with wrinkling: Report of two cases and review of the literature

Abstract

We observed two patients who had mid dermal elastolysis with wrinkling. We reviewed the pertinent features of the four cases reported in the literature and of our two cases. We also compared mid dermal elastolysis with other disorders of acquired elastolysis, such as postinflammatory elastolysis and cutis laxa, anetoderma, and (regular) cutis laxa. Our two patients with mid dermal elastolysis with wrinkling were middle-aged, white women. Physical examination showed widespread wrinkling, erythematous patches (macules), and papules. Histologic examination showed patchy loss of elastic tissue limited to the mid dermis. In one of our patients, elastolytic skin lesions appeared on areas not covered by a two-piece swimsuit. She used to sunbathe frequently. In our other patient, skin lesions were also more prominent on exposed areas. We speculate that sun exposure is one of the main causative factors of mid dermal elastolysis with wrinkling.