Mid Dermal Elastolysis: Case Report and Review of the Literature

Abstract

A new case of typical mid dermal elastolysis was studied with electron microscopy. Elastic fibers were irregularly branched or lumpy, but subcomponents of these fibers were often normal. In some fibers, loose assembly of skeleton fibrils and aggregation of dense substances were observed. Phagocytosis of normal and abnormal elastic fibers by dermal macrophages was observed.

Acquired disorders of elastic tissue: Part II. decreased elastic tissue

“…109,110,114,[119][120][121] Electron microscopy studies have also reported phagocytosis of degenerated elastic fibers by macrophages, 109,115,116,120,122 as well as loose assembly of skeleton fibrils and irregular aggregations of dense substance. 108,109,119,122,123 In many cases, specimens stained with hematoxylin and eosin appear normal, however. Hence, the unifying histopathologic criterion for the diagnosis of middermal elastolysis is bandlike loss of middermal elastic fibers sparing the papillary and lower reticular dermis (Fig 6, C).…”

Mid‐dermal elastolysis associated with Hashimoto's thyroiditis

“…Correspondingly, Prigent et al [19] and Fimiani et al [27] found increased synthesis of cathepsin G and elastases by fibroblastes in affected skin of subjects. This phenomenon may be due to inflammatory processes [21,39,45]. The onset of MDE after sunburn and phototoxic reaction has been reported, indicating that the elastolytic process could be triggered by an acute UV overdose or an idiosyncratic reaction [ 16,17,21,26].…”

“…This phenomenon may be due to inflammatory processes [21,39,45]. The onset of MDE after sunburn and phototoxic reaction has been reported, indicating that the elastolytic process could be triggered by an acute UV overdose or an idiosyncratic reaction [ 16,17,21,26]. Although photodistribution and increased UV exposure were reported in nearly half of the cases of MDE, neither typical histologic features of UV damage, nor involvement of chronic UV exposed sites, such as the face and hands, could be found generally [34].…”

Mid-Dermal Elastolysis on Face, Unusual Localization: A Case Report

“…MDE is a rare, acquired condition affecting mid-dermis presented by band-like loss of elastic tissue limited to the middermis [5] MDE and it usually affects women in their third to fifth decades of life [6].…”

“…Clinically, MDE is divided as three subtypes: type I: parallel arranged plaques of fine wrinkling to skin cleavage lines; type II: perifollicular papular protrusions with "peau d'orange" appearance; and type III: persistent reticular erythema, especially upper trunk [2,6]. The characterization of this disease lesions involves the trunk and arms, and rarely, the thighs and face [3].…”