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September 1987

An Ultrastructural Study of the Reactive Type of Elastosis Perforans Serpiginosa

Author Affiliations

Department of Dermatology Rambam Medical Center PO Box 9602 Haifa 31096, Israel; Department of Pathology Rambam Medical Center

Arch Dermatol. 1987;123(9):1127-1129. doi:10.1001/archderm.1987.01660330034007

To the Editor.—  Since elastosis perforans serpiginosa (EPS) was first described, it has been suggested that it is a phenomenon caused by a variety of abnormal elastic fibers. At least three etiologic types are now considered to be involved, ie, the idiopathic, the reactive, and the penicillamine-induced.1-3 Previous ultrastructural investigations showed that the abnormal elastic fibers in the idiopathic type differ in structure from those of the penicillamine-induced type.1,3-6 The reactive type, which is associated with different congenital disorders, mostly of the connective tissue, such as Down's syndrome, osteogenesis imperfecta, Marfan's syndrome, pseudoxanthoma elasticum, and Ehlers-Danlos syndrome (EDS), has not been as extensively studied.7 It remains to be demonstrated whether it is a unique structural form of EPS.We performed an ultrastructural study in two patients with the reactive type of EPS.

Report of Cases.—Case 1.—  A 15-year-old girl presented with osteogenesis imperfecta, type Ia,

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