Histologic examination revealed an unremarkable epidermis and a sparse perivascular lymphocytic infiltrate with plasma cells. The elastic tissue stain showed a marked decrease in elastic tissue, with fragmented elastic fibers, consistent with anetoderma.
Anetoderma, or macular atrophy, is a discrete area of skin with loss of dermal integrity that shows fragmentation or absence of elastic fibers with or without surrounding inflammation. These areas of slack skin can demonstrate the capacity to herniate with gentle palpation. The process may be divided into primary (no associated disease) or secondary anetoderma, in which the disease occurs in association with other processes, including syphilis, lupus erythematosus, lupus profundus, human immunodeficiency virus infection, and the antiphospholipid syndrome.1- 5 Other diseases reported to be associated with anetoderma, such as leprosy, urticaria pigmentosa, and pityriasis versicolor, may be coincidental. Penicillamine-induced anetoderma has also been reported.6
Generalized Flesh-Colored Pouchlike Papules. Arch Dermatol. 2001;137(5):657-662. doi: