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Linear Focal Elastosis: Diagnostic Criteria, Classification, and a Practical Approach Based on Seven Cases and a
Sveva Lenti1,2, Stefania Guida1,2, Alberto Marini1,2
1School of Medicine, Vita-Salute San Raffaele University, Milan, Italy.
International Journal of Dermatology
|August 12, 2026
Summary
Linear focal elastosis (LFE), a rare elastic tissue disorder, is now easier to diagnose using a new clinicopathologic framework. This approach aids clinicians in recognizing, diagnosing, and managing LFE effectively.
Area of Science:
- Dermatology
- Pathology
- Genetics
Background:
- Linear focal elastosis (LFE) is a rare elastic tissue disorder.
- It presents as palpable, yellowish, linear or band-like striae.
- Current diagnostic approaches lack standardization.
Purpose of the Study:
- To propose a practical clinicopathologic framework for LFE.
- To guide recognition, biopsy decisions, and management in routine practice.
- To establish working diagnostic criteria and a diagnostic algorithm.
Main Methods:
- Systematic review of 43 publications (88 patients).
- Analysis of an institutional series of 7 cases (total 95 patients).
- Development of a clinical classification and diagnostic algorithm.
Main Results:
- LFE categorized into Classic truncal and atypical types.
- Working diagnostic criteria: ≥2 major or 1 major + 2 minor criteria.
- Consistent findings: male predominance, lower back involvement, deep dermal elastosis.
Conclusions:
- The proposed framework enables confident LFE recognition and diagnosis.
- It helps avoid misdiagnosis and unnecessary interventions.
- Most patients are asymptomatic with stable outcomes under conservative management.
