A 62-year-old woman was concerned over the insidious asymptomatic development of aging and wrinkling limited to the right side of her face and neck. The dorsum of the right hand showed a similar change. There was no history of asymmetric ultraviolet light or radiation exposure. Biopsy specimens showed a substantially reduced number of elastic fibers in the wrinkled side.
It is postulated that the right side of the patient's body had failed to form a full complement of elastic tissue in the dermis. After years of actinic damage, this became evident as a remarkable premature aging of the skin, limited to the side with the elastic tissue deficit. The findings underscore a critical role for elastic tissue in the pathogenesis of wrinkles.
Shelley WB, Wood MG. Unilateral WrinklesManifestation of Unilateral Elastic Tissue Defect. Arch Dermatol. 1974;110(5):775-778. doi:10.1001/archderm.1974.01630110069021