A female patient in her teens presented with a 4-year history of bilateral erythematous plaques lateral to each elbow. The patient described the lesions as sensitive to touch, as well as mildly pruritic and xerotic. She had not previously sought treatment. Her medical history and findings from a review of systems were otherwise negative. Examination revealed arcuate to annular, erythematous, hyperkeratotic plaques measuring 2 cm and 1.5 cm on the right and left arm lateral to the elbow, respectively (Figure, A). A punch biopsy of the plaque on the right arm (Figure, B) and elastin staining (Figure, C) were performed.