An unusual periumbilical plaque

Two cases of periumbilical perforating pseudoxanthoma elasticum with dermoscopic and histopathologic features

“…The purported pathogenesis is stretching of the abdominal wall connective tissue, for example, in multiparous and obese patients causing alteration and calcification of elastic fibres which undergo transepidermal elimination. It classically presents as a periumbilical hyperpigmented plaque on which keratotic ulcerated papules develop.…”

“…Stretching of abdominal wall connective tissue, for example, in obese and multiparous women is a purported cause of this disease . Histopathology reveals transepidermal elimination of altered calcific elastic fibres classically described as having ‘ravelled wool’ appearance . Few reports have been published detailing the dermoscopic features of this disease.…”

“…It classically presents with mildly pruritic keratotic papules on a periumbilical yellowish plaque. Stretching of abdominal wall connective tissue, for example, in obese and multiparous women is a purported cause of this disease . Histopathology reveals transepidermal elimination of altered calcific elastic fibres classically described as having ‘ravelled wool’ appearance .…”

SkIndia Quiz 39: Pebbly flexural skin in a young female

“…Diagnosis can be confirmed using special stains for elastic fibers (e.g., Verhoeff van Gieson, Orcein) and calcium deposits (e.g., von Kossa). [6]…”

Appearances in dermatopathology: The diagnostic and the deceptive

“…It is a classical histopathological description seen in pseudoxanthoma elasticum (PXE). Biopsy from a lesion will show small, fragmented, wavy and clumped eosinophilic elastic fibers, giving a "ravelled wool" appearance [50] [ Figure 19]. Similar appearance of elastic fibers can also be seen in D-penicillamine-induced PXE and periumbilical PXE.…”