A 45-year-old female with a three-year history of bilateral ocular angioid streaks was referred to our dermatology department Kırşehir Ahi Evran University for the evaluation of persistent cutaneous lesions, present since childhood ( Figure 1, A–D ). The patient was previously diagnosed with pigmented contact dermatitis 5 years ago, in a different dermatology outpatient clinic. Dermatological examination in our dermatology department showed confluent yellowish papules on both sides of the neck ( Figure 2A ). Dermoscopic examination revealed reticulated yellow-to-white clods on a light red background, along with defocused linear irregular vessels ( Figure 2B ). Histopathological examination showed mild epidermal atrophy, accumulation of swollen clumped fibers, mild inflammatory cell infiltration, and dilated dermal vessels ( Figure 2C ). Elastic van Gieson staining showed fragmented elastic fibers. Based on the clinical, dermoscopic and histopathological features, a diagnosis of pseudoxanthoma elasticum was made. Detailed imaging studies showed no systemic involvement except for ocular lesions.
Figure 1 .
Color fundus photographs. (A, B) Angioid streaks in both eyes (white arrows). (C, D) Angioid streaks in fundus autofluorescence and red free images of the left eye (white arrows).
Figure 2 .
Dermatologic, dermoscopic, and histopathologic examination. (A) Dermatological examination showed confluent yellowish papules on the neck. (B) Dermoscopic examination revealed reticulated yellow-to-white clods on a light red background, along with disfocused linear irregular vessels. (C) Histopathological examination showing dermal accumulation of swollen clumped fibers.
- Dermoscopic features of pseudoxanthoma elasticum Kawashima S, Togawa Y, Miyachi H, Matsue H. Clin Exp Dermatol.2018;43(2):175-179. CrossRef PubMed
- Dermoscopy, Optical Coherence Tomography, and Histological Correlation of Pseudoxanthoma Elasticum Persechino F, Giordano D, Marini CD, Franceschini C, Ardigò M, Persechino S. Dermatol Pract Concep.2019;9(3):209-210. CrossRef PubMed