Linear focal elastosis: histopathologic diagnosis of an uncommon dermal elastosis

Linear focal elastosis is an uncommon dermal elastosis that occurs predominantly on the back. Although first described in the lumbar region of elderly white men, more recent reports note similar findings on the trunk and limbs of adolescent Asian men.

We present a typical case of an eighty-three year old white man with a one-year history of asymptomatic linear yellow and erythematous plaques on his lumbar region.

Light microscopic examination revealed skin with an unremarkable epidermis with coarsely clumped elastic fibers in the reticular dermis, which were highlighted by an elastic tissue stain.

The histopathologic differential diagnosis includes pseudoxanthoma elasticum, connective tissue nevus, elastofibroma, and solar elastosis. Although some of these diagnoses can be excluded by histologic examination, correlation with the clinical findings is necessary to arrive at the correct diagnosis of linear focal elastosis. Linear focal elastosis is an uncommon dermal elastosis that was originally described as asymptomatic linear yellow plaques in the lumbar region in elderly white males 1. Recent reports have extended the spectrum of this entity to include red-yellow linear atrophic to raised plaques on the trunks and limbs of adolescent males, predominantly of Asian descent. Twenty-one cases of linear focal elastosis have been reported in the literature. We report an additional case of linear focal elastosis in an elderly male and review the literature.