Track: Case Reports

Abstract:

Anetoderma is a rare, benign cutaneous disorder characterized by focal dermal elastolysis, presenting clinically as macular atrophy or flaccid skin. It can occur de novo (primary) or in association with inflammatory, infectious, autoimmune, or neoplastic processes (secondary). Cases related to medications, neonatal onset, and familial inheritance have also been reported. Despite well-described associations, its pathogenesis remains unclear. Prompt recognition is crucial to guide evaluation for potential underlying conditions. We present a 35-year-old male with a two-year history of a spreading upper body rash involving the arms, back, and face. He reported no discomfort or prior medical issues. Physical exam revealed soft, flesh-colored papules. Biopsy demonstrated a perivascular lymphocytic infiltrate with plasmacytoid cells, numerous melanophages, and loss of elastic fibers on elastin stain. Spirochete stain was negative. HIV and tuberculosis testing were negative; syphilis testing was not completed. The patient was lost to follow-up, leaving the underlying etiology unresolved. This case underscores the importance of histopathologic identification of anetoderma and its potential to reveal serious systemic conditions. Through this patient’s presentation, we review key differential diagnoses and reinforce the diagnostic and clinical significance of this uncommon entity.

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Gelan Shamloul