White fibrous papulosis of the neck

Area of Science:

• Dermatology
• Pathology
• Aging Research

Background:

• White fibrous papulosis of the neck (WFPN) and pseudoxanthoma elasticum-like papillary dermal elastolysis (PXE-PDE) represent distinct clinicopathologic patterns associated with intrinsic aging.
• Understanding the differential diagnosis between these conditions is crucial for accurate diagnosis and management.

Observation:

• A 56-year-old man presented with multiple, discrete, nonfollicular papules on the neck.
• Clinical examination revealed clearly marginated, whitish papules consistent with WFPN.
• Histopathologic analysis confirmed superficial dermal fibrosis with scant elastolysis, characteristic of WFPN, distinguishing it from PXE-PDE which shows elastolysis without fibrosis.

Findings:

• The presented case was diagnosed as WFPN, a manifestation of intrinsic aging.
• The patient experienced no recurrence over a 3-year follow-up period.
• Surgical intervention is a potential treatment option for well-circumscribed WFPN lesions.

Implications:

• This case reinforces the distinct clinical and histopathologic features differentiating WFPN from PXE-PDE.
• It suggests that WFPN is a stable condition with a favorable prognosis, especially when treated appropriately.
• The findings support surgical excision as a viable and effective treatment for localized WFPN, potentially preventing recurrence.