Acquired cutis laxa: a clinical review

Area of Science:

• Dermatology
• Internal Medicine
• Pathology

Background:

• Acquired cutis laxa (ACL) is a rare, nonhereditary condition characterized by loose, inelastic skin.
• ACL is associated with various systemic conditions, including inflammatory, autoimmune, neoplastic diseases, infections, and medications.

Purpose of the Study:

• To review the demographical, clinical, and histological features of ACL.
• To explore associated disorders, pathogenetic mechanisms, and therapeutic options for ACL.
• To propose an algorithm for the workup of patients with ACL.

Main Methods:

• A systematic literature review was conducted using PubMed/Medline and EMBASE databases.
• Included articles covered ACL with no restrictions on participant demographics or publication date.
• Ninety-eight articles comprising 110 patients were analyzed.

Main Results:

• The mean age of presentation was 36.4 years, with a M:F sex ratio of 1.24.
• ACL was most commonly associated with inflammatory (43%) and neoplastic disorders (27%).
• In neoplastic-associated cases, ACL preceded malignancy by an average of 2.4 years; in inflammatory cases, ACL followed the disorder by months to years.

Conclusions:

• Dermatologists must be aware of ACL's associations for timely screening and management.
• Early recognition of ACL can facilitate the detection of underlying systemic diseases.
• Further research into pathogenetic mechanisms and standardized therapeutic approaches is warranted.