Elastólisis de la dermis papilar similar a pseudoxantoma elásticoPseudoxanthoma elasticum-like papillary dermal elastolysis (PXE-PDE) is a clinical-pathologic entity characterized by skin lesions similar to those of PXE itself in addition to the absence or marked loss of elastic fibers in the papillary dermis. 1 We report a new case of PXE-PDE, focusing on its pathogenesis and clinical, pathologic, and dermatoscopic features. We also review the literature.The patient was a 74-year-old woman with a history of chronic bronchiectasis since childhood, aortic insufficiency, and age-related macular degeneration. She presented with asymptomatic lesions on the neck and axillas that had appeared 4 months earlier. Physical examination revealed millimetric, nonfollicular, flesh-colored papules converging