Late‐onset Focal Dermal Elastosis—dermatoscopic and ultrasonographic assessment of this rare entity and literature review

Abstract

Late-onset Focal Dermal Elastosis-dermatoscopic and ultrasonographic assessment of this rare entity and literature reviewDear Editor, Late Onset Focal Dermal Elastosis (LOFDE) is a rare, acquired cutaneous entity. Clinically, it usually presents as multiple, small, flat, white to pale yellow papules located on the sides of the neck and flexural areas. [1][2] The lesions might be asymptomatic or pruritic and generally occur in the elderly skin. Mainly women are affected. 3 In several reports regarding LOFDE, only a single case was described in a male patient. 4 The histopathological hallmark of LOFDE is the accumulation of the structurally normal elastic tissue in the mid and deep reticular dermis forming conglomerates pushing up collagen bundles. 3 Although LOFDE might clinically resemble pseudoxanthoma elasticum (PXE), their histopathological features differ, and no systemic disorders have been found in this condition. Other differential diagnoses include elastofibroma, papillary dermal elastolysis, nevus elasticus and Buschke-Ollendorff syndrome. 1 The pathogenesis of this entity is not known; however, some theories have been proposed. Since there are no clues of solar elastosis in histopathology, ageing not related to sun damage might have an impact on the appearance of the skin lesions. 3F I G U R E 1 Clinical image of LOFDE: (A) multiple white papules on the right thigh, (B) multiple white papules located unilaterally on the right shin.