A case of papular elastorrhexis

An 11-year-old girl presented with a 2-year history of flesh-colored papules on her extremities (Figure 1). The lesions were asymptomatic, of oval or irregular shape and increased gradually both in size and numbers without any treatment. She denied a history of any other inflammatory dermatoses or trauma on the involved area. There was no family history of similar lesions. Dermatological examination showed that multiple flesh-colored, non-follicular papules were discrete and distributed over her lower limbs. The lesions were approximately 5–10 mm in diameter, of various shapes and slightly hard. No other primary or secondary lesions (erythema or scales, etc.) can be seen around the involved area. Histopathological examination of the skin lesion on the left thigh revealed hyperkeratosis, slight perivascular lymphocytes infiltration and a mild hyperplasia of collagen fiber in the dermis. Elastic tissue staining (Resorcinol-Fuchsin stain) showed a significant reduction, fragmentation or complete loss of elastic tissue in upper and mid dermis (Figure 2). Based on the clinical and histopathological features, a diagnosis of papular elastorrhexis was made. No treatment was performed because of the benign process of this disease and asymptomatic character of the lesions. She was followed up for one year and showed no improvement in the involved lesions