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Dermatology
Atrophies of Connective Tissue
Built from Dermatology, 5th Edition
What’s inside
9 sections · 79 slides
Overview
- What atrophies of connective tissue are
- Conditions covered in this chapter
Mid-dermal elastolysis
A band of elastic fiber loss confined to the mid dermis
- Mid-dermal elastolysis (MDE): key features
- Epidemiology and suspected triggers
- How mid-dermal elastolysis is thought to develop
- Mid-dermal elastolysis: proposed mechanisms
- Three clinical patterns of mid-dermal elastolysis
- Wrinkling can be a small well-circumscribed patch or spread diffusely over the trunk or arm.
- Course, sites, and impact of mid-dermal elastolysis
- A special elastic-tissue stain (such as orcein) is needed to see the fiber loss - it will not show on routine stains.
- Disorders of elastic tissue
- Mid-dermal elastolysis: other look-alikes
- Mid-dermal elastolysis: treatment
Anetoderma
Localized pockets of slack skin from focal elastic fiber loss
- Anetoderma: what it is
- Anetoderma: who gets it, and why
- Classification of anetoderma
- Anetoderma: the buttonhole sign
- Panel A shows a soft, skin-colored papule that herniates (bulges) when pressed.
- Secondary anetoderma: a wide range of triggers
- Secondary anetoderma – associated conditions
- Secondary anetoderma – associated conditions (continued)
- Secondary anetoderma at sites of prior disease
- Anetoderma in premature infants
- Elastic-tissue stains show a focal, often near-complete loss of elastic fibers in the papillary and/or reticular dermis.
- Anetoderma: telling it apart from look-alikes
- Anetoderma: treatment
- Primary anetoderma - additional presentation
Striae
Stretch marks: dermal breaks from mechanical and hormonal stress
- Striae: a very common condition
- Striae: epidemiology and pathogenesis
- How a stretch mark evolves
- Panel A shows early striae rubrae - red, raised lines on the abdomen.
- Where striae appear, by age and setting
- Common anatomic sites of striae and linear focal elastosis
- Striae in pregnancy and with corticosteroid use
- Striae: what the biopsy shows
- Linear focal elastosis: a striae look-alike
- Linear focal elastosis - raised yellow bands
- Striae: treatment options
Atrophoderma of Pasini and Pierini
Depressed brown patches with a sharp, 'cliff-drop' edge
- Atrophoderma of Pasini and Pierini: overview
- Suspected cause and typical sites
- The 'cliff-drop' border
- Multiple light brown patches with subtle depression are visible on the back.
- Coalescent hyperpigmented patches of atrophoderma
- Course and overlap with morphea
- What the biopsy shows
- Atrophoderma vs morphea vs anetoderma
- Atrophoderma of Pasini and Pierini: treatment
Follicular atrophoderma and related syndromes
Pinpoint pits at hair follicles, sporadic or part of a genetic syndrome
- Follicular atrophoderma: the basic finding
- Atrophoderma vermiculatum: a facial pitting disorder
- Atrophoderma vermiculatum - honeycomb facial pitting
- The 'keratosis pilaris atrophicans' family
- How the follicle gets scarred
- Syndromes linked to atrophoderma vermiculatum
- Genodermatoses that cause many basal cell carcinomas
- Bazex-Dupre-Christol syndrome
- Conradi-Hunermann-Happle syndrome
Atrophia maculosa varioliformis cutis
Small, scar-like facial depressions with no history of injury
- Atrophia maculosa varioliformis cutis
- Atrophia maculosa varioliformis cutis - facial depressions
- Telling it apart from similar scars
Piezogenic pedal papules
Fat herniating through connective tissue under pressure at the heel
- Piezogenic pedal papules: what and why
- Clinical appearance and management
- Soft, skin-colored papulonodules are visible along the heel margin.
- Piezogenic pedal papules on the medial heel
- Pedal papules of infancy
- Soft nodules are seen on the medial and plantar (sole-side) surfaces of the foot in an infant.
- Pedal papules of infancy persisting in a young child
Other atrophies of connective tissue
Cutaneous atrophy as a shared feature of several other diseases
- Other causes of cutaneous atrophy
- Elastic fiber loss vs collagen loss: the key split
- Key takeaways
- References
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- Dermatology, 5th Edition (2-Volume Set)