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Confetti-like macular atrophy: A new entity?

Berna Aksoy¹, Hüseyin Ustün, Rukiye Gülbahçe

¹Dermatology Clinic, TDV 29 Mayis Private Ankara Hospital, Ankara, Turkey. bmaksoy@mynet.com

The Journal of Dermatology

|November 3, 2009

Summary

Two patients with skin conditions showed clinical signs of atrophoderma but histopathological findings of anetoderma. These cases may represent a new clinicopathological entity in dermatology.

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Area of Science:

Dermatology
Pathology
Histopathology

Background:

Anetoderma is defined by herniated atrophic macules and dermal elastic fiber loss.
Atrophoderma presents as depressed, atrophic patches with thickened dermal collagen and absent elastolysis.
Atrophoderma elastolyticum discretum exhibits atrophoderma-like clinical signs but anetoderma-compatible histopathology.

Observation:

Two female patients presented with diffuse, hypopigmented, atrophic, shiny macules on the upper limbs and trunk.
Histopathology revealed atrophic epidermis, disorganized collagen bundles, and variable elastic fiber loss.
Clinical presentation lacked depressed or herniated macules, with lesions at skin level.

Findings:

Histopathological findings demonstrated features of both atrophoderma and anetoderma.
One patient had upper dermal elastic fiber fragmentation, while the other showed near-complete loss throughout the dermis.
The observed clinicopathological features align with neither classic atrophoderma nor anetoderma.

Implications:

These cases suggest a potential novel clinicopathological entity merging features of atrophoderma and anetoderma.
Further research is needed to define this condition and its relationship to existing dermatoses.
Understanding this entity could improve diagnostic accuracy and patient management for similar presentations.