A Clinicoimmunohistopathologic Study of Anetoderma: Is Protruding Type More Advanced in Stage Than Indented Type?

Abstract

Background. The clinical and histopathologic classification of anetoderma are not well characterized. Objective. We aimed to investigate the clinical and histopathologic characteristics of anetoderma and to correlate clinical phenotypes with immunohistopathologic findings. Methods. We retrospectively reviewed the medical records of 30 patients with anetoderma and performed immunohistochemistry for elastin, fibrillin-1, metalloproteinase- (MMP-) 2, MMP-7, MMP-9, and MMP-12, and tissue inhibitor of metalloproteinase- (TIMP-) 1 and TIMP-2. Results. Protruding type (n = 17) had a longer disease duration and more severe loss of elastin, without changes in fibrillin, than indented type (n = 13). MMP-2 and MMP-9 showed significantly higher expressions in the dermis compared with controls (p < 0.05). MMP-7 and MMP-12 showed little expressions in both anetoderma and control tissue. TIMP-1 was highly expressed in anetoderma lesions and controls. TIMP-2 expression was variable. Conclusions. Our findings suggest that protruding type anetoderma may represent a more advanced stage and that MMP-2 and MMP-9 could be responsible for elastic fiber degradation in anetoderma.

Optimal Timing of Surgical Excision in Pediatric Pilomatricoma: Association between Clinicopathological Features and Cosmetic Outcomes

“…Our findings suggest that elastolysis and catalytic mechanisms are more progressive in patients with delayed excision. As secondary anetoderma with underlying histopathological change can affect delayed wound healing and scar formation 10,20,21 , it would be associated with poor surgical outcomes. The tent sign on physical examination is a pathognomonic sign of pilomatricomas.…”

Multibacillary Leprosy Presenting as Anetoderma in a Young Teenager

“…Primary anetoderma occurs idiopathically from normal skin and is strongly associated with antiphospholipid syndrome. Secondary anetoderma is reported with tuberculosis, leprosy, lupus, syphilis, granuloma annulare, B- and T-cell lymphomas, and other conditions [ 5 ]. The exact etiology of anetoderma is unknown, but the condition is associated with an increase in elastolysis [ 6 ].…”

Spreading Papules and Nodules in an 11-Year-Old Girl

“…The disease course does not differ based on the presence or absence of inflammatory infiltrate. 5 On immunochemistry, severe or total loss of elastin was found in 66.6% of lesions of the protruding type and 40% of lesions of the indented type. 5 In this case, a biopsy was performed demonstrating a sparse interstitial infiltrate composed of histiocytes, many multinucleated, highlighted by CD68 (Figure 5).…”