Acquired Disorders of Dermal Connective Tissue

Abstract

This chapter reviews acquired changes in dermal connective tissue during normal ageing and in disease processes, including photodamage. Corticosteroids are a potent cause of dermal atrophy, which may also be congenital or induced by inflammatory disorders related to morphoea. Enzymatic degradation of elastic tissue results in localised or generalised skin laxity, which resembles genetic disorders such as pseudoxanthoma elasticum and cutis laxa. In contrast, some disorders are characterised by excessive deposition of collagen or elastic tissue. Fibrosis is associated with contracture, which causes deformity and restricted movement as in palmoplantar fibromatosis. Several chemical environmental triggers induce diffuse fibrosis resembling systemic sclerosis. Keloids represent an abnormal scarring response to trauma. Finally, dermal connective tissue components may be extruded via the epidermis in perforating disorders such as elastosis perforans serpiginosa.