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GIORNALE ITALIANO DI DERMATOLOGIA E VENEREOLOGIA

A Journal on Dermatology and Sexually Transmitted Diseases


Official Journal of the Italian Society of Dermatology and Sexually Transmitted Diseases
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Giornale Italiano di Dermatologia e Venereologia 2007 October;142(5):607-11

language: English

Fibroelastolytic papulosis of the neck: two new cases with an ultrastructural study

Cannavò S. P. 1, Rongioletti F. 2, Guarneri F. 1, Borgia F. 1, Ciambellotti A. 2, Zaccaria E. 2, Todaro F. 1, Cavallar V. 3

1 Section of Dermatology Department of Social Territorial Medicine University of Messina, Messina, Italy
2 Section of Dermatology DISEM, University of Genoa, Genoa, Italy
3 Laboratory of Ultrastructural Pathology Department of Human Pathology University of Messina, Messina, Italy


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Two new cases of fibroelastolytic papulosis of the neck are reported. This cutaneous disease is characterized by small, asymptomatic, round-to-oval, normal to whitish-ivory or yellow, isolated or confluent papules, localized on the lateral and dorsal aspects of the neck. Histopathological examination showed marked diminution or complete loss of fine elastic fibers, i.e. the delicate oxytalanique and elaunic components in the papillary dermis, associated with focal fibrosis, characterized by a marked increase in the density of the collagen network in the upper reticular dermis in both cases. A slight thickening and a general reduction of the elastic plexus were also detected. An ultrastructural study in one patient revealed regressive changes of the elastic fibers. The observed resemblance of fibroelastolytic papulosis of the neck to “white fibrous papulosis of the neck” and “pseudoxanthoma elasticum-like papillary dermis elastolysis”, and their histologic similarities in terms of the microscopic changes observed in intrinsic aging link these cutaneous diseases and reinforce the unifying concept of “age-related fibroelastolytic syndrome”. This term stresses their common pathogenesis and histologic hallmarks. Their distinction from pseudoxanthoma elasticum is important to spare the patients from useless investigation. Routine histopathology is not specific and a clinicopathologic correlation with special microscopic stains is necessary to make the correct diagnosis.

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