Rediscovering perifollicular elastolysis: A hitherto undocumented entity in India

Abstract

Perifollicular elastolysis, also known as papular acne scars is a common but taken for granted entity. It appears as asymptomatic whitish yellow papules on the trunk and proximal arms. Histologically there is loss of elastin around the pilosebaceous follicles. The lesions are the result of a scarring process that appear as papules and are often mistaken for papules of acne and are treated. A knowledge of this entity which has never been described before in India is being reiterated.

Intertriginous perifollicular elastolysis: A report of 2 cases

“…Perifollicular elastolysis occurs on the upper back, upper chest, or upper arms and presents as 1-to 3mm round-to-oval papules that are white, yellow or skin-colored. 4,7 In our cases, the patients uniquely presented with lesions on or near the breasts. To our knowledge, this is the first report of perifollicular elastolysis on the breast or in intertriginous distribution.…”

“…Since then, it has often been reported as a rare condition, but it may be underreported. 6,7 These subtle changes may often be overlooked by clinicians or simply ignored by patients, whereas the focus is on treating active acne flares, dyspigmentation, and subsequent pitted scars. Perifollicular elastolysis is on a continuum with acne vulgaris.…”

“…Some investigators suggest this condition is untreatable. 7 It is important for the clinician to recognize, diagnose, and, perhaps most importantly, counsel patients on the etiology of this condition and its lack of response to treatment, thus preventing unnecessary frustration and expense related to futile management strategies.…”

Commentary on A Neglected Acne Scar Type: Papular Acne Scars and Their Correlations With Keloid Scars

“…It is also described as perifollicular elastolysis. 10 This seems a little different than papular elastorrhexis in its perifollicular positioning, different patient demographics, and relationship to acne, although some believe it to be similar to papular acne scarring. 11 If papular acne scars resolve, they may appear like herniated tissue and leave a compressible papule but with a palpability unlike true anetoderma.…”

Anetodermic lesions following pityriasis rosea and impetigo

“…However, histopathological picture of our patient was consistent with the diagnosis of perifollicular elastolysis. [14][15][16][17][18][19][20][21][22] It is characterized by atrophic, round or oval, white to pink, small or very small, non confluent, asymptomatic lesions, with a central pilosebaceous follicle. 15,16,18 These lesions occur on the neck, shoulders, arms and upper trunk.…”