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Mid-dermal elastophagocytosis presenting as a persistent reticulate erythema.
M J Bannister1, D M Rubel, S Kossard
1Skin and Cancer Foundation Australia, Sydney, New South Wales, Australia. mbannister@bigpond.com
The Australasian Journal of Dermatology
|March 10, 2001
Summary
Diffuse reticulate erythema in sun-damaged skin may indicate elastophagocytosis. This finding expands the clinical spectrum of skin conditions related to sun damage and immune responses.
Area of Science:
- Dermatology
- Pathology
- Immunology
Background:
- Chronic sun exposure damages skin, leading to various dermatoses.
- Reticulate erythema can manifest in sun-damaged skin, but its specific causes are not fully understood.
- Previous conditions like actinic granuloma and granuloma annulare have distinct presentations.
Observation:
- Two male patients presented with widespread, persistent reticulate erythema on sun-damaged trunk skin.
- One patient had a fine papular component; neither had annular lesions.
- One patient was positive for human immunodeficiency virus (HIV).
Findings:
- Skin biopsies revealed an interstitial histiocyte infiltrate with elastic fibers in the upper dermis.
- Scant perivascular lymphocytic inflammation was noted, without typical granuloma annulare features.
- Elastic stains demonstrated focal mid-dermal elastolysis, suggesting elastic fiber degradation.
Implications:
- Diffuse reticulate erythema in sun-damaged skin may serve as a clinical marker for elastophagocytosis.
- This presentation broadens the known clinical spectrum of mid-dermal elastolysis and related phenomena.
- Understanding this condition is crucial for accurate diagnosis and management of sun-induced skin changes.