Follicular occlusion disease with elimination of abnormal elastic tissue

A case of follicular occlusion disease with notably increased and abnormal elastic tissue and transepidermal elimination of elastic fibers is reported. This combination of findings has traditionally been regarded as unique to elastosis perforans serpiginosa and, to our knowledge, has not previously been described in other follicular diseases. It is hypothesized that the histopathologic changes seen in this case might be a nonspecific secondary alteration in the dermis caused by long-standing chronic inflammation and/or repeated exposure of the dermis to follicular contents.