Two cases of linear focal elastosis: different histopathologic findings.

Abstract

Case 1 A 16-year-old Korean man presented with asymptomatic erythematous striae-like bands on his back which had been present for 6 months and had migrated to his shoulder ( Fig. 1a). He had no history of corticosteroid therapy, rapid gain or loss of weight, debilitating infection or illness. Histopathologically, fine, fragmented elastic fibers were shown in the dermis, but there were no clumped elastic fibers ( Fig. 2a). Electron microscopy showed an irregular, fragmented, electron-dense granular substance and a fragmented, electron-lucent substance between the normal collagen fibers, and no microfibrils ( Fig. 3a). This indicates the degeneration of elastic fibers. Figure 1Open in figure viewerPowerPoint Asymptomatic, palpable, erythematous bands extending horizontally across the middle and lower back and propagating to the shoulder. (b) Asymptomatic, palpable, yellowish, striae-like bands extending horizontally across the middle and lower back Figure 2(a)Open in figure viewerPowerPoint The number of elastic fibers was decreased, and fine, fragmented, elastic fibers were observed in the dermis (Verhoeff’s stain, × 200). (b) Massive, well-demarcated, clumped, elastic fibers were observed in the mid-dermis (Verhoeff’s stain, imes; 200) Figure 3(a)Open in figure viewerPowerPoint Electron micrograph showing irregular, fragmented, electron-dense granular substance (arrow) and fragmented, electron-lucent substance (asterisks) between normal collagen fibers (C) (original magnification, × 39,100). (b) Electron micrograph showing fragmented, electron-dense granular substance (arrow) and numerous microfibrils (asterisks) near the substance. No abnormalities were seen in the collagen fibers (C) (original magnification, × 39,100) Case 2 An 18-year-old Korean man presented with asymptomatic yellowish striae in the lumbar area which had been present for 2 years ( Fig. 1b). He had no specific medical history. Massive, well-demarcated basophilic fibers were observed in the dermis with light microscopy. These fibers were stained positively with elastic stain ( Fig. 2b). Electron microscopy showed a fragmented, electron-dense granular substance and numerous microfibrils near the substance ( Fig. 3b), which suggests active elastogenesis.