A Case of Papular Elastorrhexis: Differential Diagnosis with Eruptive Collagenoma / 대한피부과학회지

Papular elastorrhexis is a rare entity, possibly a form of connective tissue nevi, characterized by asymptomatic white papules on the trunk and extremities first appearing during childhood or adolescence. Histopathologically, the elastic fibers are decreased and may appear in thin and fragmented forms. This rare condition has clinical and histological findings that overlap with those of other connective tissue nevi, making diagnosis a challenge for dermatologists. Herein we report the case of a 27-year-old Korean female presenting with asymptomatic 2~5 mm sized whitish papules on both extremities and showing histopathologic findings of increased layers of collagen fibers and decreased and fragmented elastic fibers in the dermis.

The Importance of Collagen Tissue in Papular Elastorrhexis, Eruptive Collagenoma, and Nevus Anelasticus

BACKGROUND: Papular elastorrhexis (PE), eruptive collagenoma (EC), and nevus anelasticus (NA) are described as multiple small papules with decrease, fragmentation, or lack of dermal elastic fibers. These diseases are suggested to be the same entity. The change of collagen fibers in the conditions has not been addressed to date. OBJECTIVE: We compared the clinical features of the 3 diseases and investigated changes in the collagen fibers involved. METHODS: Twenty-four cases of PE, 12 cases of EC, and 2 cases of NA found in PubMed and the Korean database were reviewed. Changes in dermal collagen fibers in 10 cases with histological figures were investigated. RESULTS: There were significant similarities between the 3 entities in terms of their clinical features. Four patients with PE and 2 with EC with fine, dense collagen fibers were women who had multiple white to hypopigmented, slightly indurated to firm, millimeter-size papules on the trunk and/or extremities that progressed gradually after developing in the patients' first to third decades. CONCLUSION: The 3 conditions are the same clinical entity in our opinion; such cases with fine, dense collagen manifest typical features.

The Importance of Collagen Tissue in Papular Elastorrhexis, Eruptive Collagenoma, and Nevus Anelasticus

BACKGROUND: Papular elastorrhexis (PE), eruptive collagenoma (EC), and nevus anelasticus (NA) are described as multiple small papules with decrease, fragmentation, or lack of dermal elastic fibers. These diseases are suggested to be the same entity. The change of collagen fibers in the conditions has not been addressed to date. OBJECTIVE: We compared the clinical features of the 3 diseases and investigated changes in the collagen fibers involved. METHODS: Twenty-four cases of PE, 12 cases of EC, and 2 cases of NA found in PubMed and the Korean database were reviewed. Changes in dermal collagen fibers in 10 cases with histological figures were investigated. RESULTS: There were significant similarities between the 3 entities in terms of their clinical features. Four patients with PE and 2 with EC with fine, dense collagen fibers were women who had multiple white to hypopigmented, slightly indurated to firm, millimeter-size papules on the trunk and/or extremities that progressed gradually after developing in the patients' first to third decades. CONCLUSION: The 3 conditions are the same clinical entity in our opinion; such cases with fine, dense collagen manifest typical features.

A Case of Linear Eruptive Collagenoma on the Chest and Neck / 대한피부과학회지

Eruptive collagenoma is a rare acquired type of connective tissue nevus that predominantly consists of collagen. It usually presents as multiple, asymptomatic, firm, flesh-colored or pink nodules or plaques that are symmetrically distributed over the trunk and upper extremities. Four cases of eruptive collagenoma in linear or zosteriform arrangements have been reported in the English literature. A 16-year-old boy presented with multiple asymptomatic erythematous papules and nodules on the left side of his sternal margin and the posterior side of his left neck. A punch biopsy taken from one of the nodules on the chest showed thickened collagen fibers in the dermis. Masson-Trichrome staining revealed an increase in the collagen fibers, which were broad and arranged haphazardly, and the elastic staining indicated a reduction in the elastic fibers in the dermis, which are findings that are consistent with collagenoma. We report a case of eruptive collagenoma that presented in a linear arrangement, which is a rare distribution pattern for connective tissue nevi.

Study of the Clinical Features of Acquired Collagenoma / 대한피부과학회지

BACKGROUND: A collagenoma or connective tissue nevus of the collagen type is a hamartoma consisting predominantly of collagen. Collagenomas are divided into the inherited and acquired types. The acquired forms include eruptive and isolated collagenoma. However, few studies have assessed the characteristics of patients with acquired collagenoma. OBJECTIVE: The aim of this study was to analyze the clinical characteristics of patients with acquired collagenoma. METHODS: We reviewed the medical records and clinical photographs of 23 patients who had been diagnosed histopathologically with acquired collagenoma by biopsy during the last 12 years, from January 2002 to December 2013. In addition, 11 cases of eruptive or isolated collagenomas previously reported in the Korean literature were added. RESULTS: In total, 34 cases of acquired collagenoma were assessed. Of the 34 cases, 53% were men and 47% were women. The mean age at diagnosis was 20.0 years for the patients with eruptive collagenoma and 29.1 years for the patients with isolated collagenoma. In the cases of eruptive collagenoma, multiple, flesh-colored or whitish papules on the trunk were predominant. On the other hand, in the cases of isolated collagenoma, solitary, flesh-colored plaques on the palms or soles were common features. Collagenomas in most cases were asymptomatic (79.4%). However, some patients with collagenomas had other symptoms such as tenderness or pruritus. There was no traumatic history in any case. CONCLUSION: Our study showed that the clinical features of patients with acquired collagenoma share many similarities with those in previously reported studies, with some differences. This study is expected to help us understand and obtain more information on the clinical diagnosis of acquired collagenoma.

A Case of Eruptive Collagenoma / 대한피부과학회지

Eruptive collagenoma is an acquired connective tissue nevus composed predominantly of collagen. We present a case of eruptive collagenoma in a 13-years-old female who had asymptomatic multiple 3 to 9 mm sized flesh colored scattered papules on both limbs. In addition, the differential diagnosis and other types of cutaneous collagenomas are briefly discussed.

A Case of Eruptive Collagenoma on the Left Calf

Eruptive collagenoma is an acquired connective tissue nevus without family history. It is typically described as numerous small papules or nodules on the trunk and arms with histopathological features of decreased or degenerated elastic fibers. We report a case of a 16-year-old male who presented with multiple asymptomatic 2 to 5 mm sized yellowish grouped papules on the left calf. Histopathologically, the lesion showed thickened homogenized collagen fibers highlighted by Masson trichrome stain and decreased and fragmented elastic fibers stained by Verhoeff-van Gieson stain. The skin lesion was diagnosed as eruptive collagenoma and no treatment was provided.

A Case of Eruptive Collagenoma / 대한피부과학회지

Eruptive collagenoma is a connective tissue nevus, which can occur even if there is no family history of the condition. We report a case of eruptive collagenoma in a 44-year-old woman, who had had multiple, variable-sized, yellowish papules on her neck since childhood. The histopathologic findings showed thickened, homogenized collagen fibers and decreased elastic fibers.