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February 1978

Pseudoxanthoma Elasticum With Transepidermal Elimination

Author Affiliations

From the Departments of Dermatology (Drs Schwartz and Richfield) and Pathology (Dr Richfield), University of Cincinnati Medical Center. Dr Schwartz is now with the Department of Dermatology, Roswell Park Memorial Institute, Buffalo.

Arch Dermatol. 1978;114(2):279-280. doi:10.1001/archderm.1978.01640140089023

Pseudoxanthoma elasticum (PXE) with transepidermal elimination was observed in a patient and diagnosed histologically in a single cutaneous plaque; it was the only manifestation of her disease. Recently, Lund and Gilbert1 clearly established that most cases of coexistent PXE and elastosis perforans serpiginosa (EPS) are, in fact, perforating PXE. We suggest that all patients with apparent EPS or with solitary verrucous plaques be carefully examined for possible PXE.

Report of a Case  A 59-year-old woman was first seen in August 1975 for evaluation of a periumbilical hyperpigmented plaque (Fig 1). In about 1970, the patient first noted the asymptomatic lesion, which had not changed in size, color, or other characteristics since. No other lesions were present. She was hospitalized in 1968 for epistaxis; no cause was found. In 1971 during an admission for atrial fibrillation, fluoroscopy showed no intracardiac or coronary artery calcifications.Her parents, three siblings, five children,

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