Authors : Krishnendra Varma, Varun Kumar
DOI : 10.18231/j.ijced.2020.020
Volume : 6
Issue : 1
Year : 2020
Page No : 95-97
Elastosis perforans serpiginosa is a rare primary perforating disorder. In EPS, there is elimination of
altered elastic fibres from papillary layer of dermis to epidermis which is described as transelimination
disorder. It is characterized as multiple hyperkeratotic umbilicated papule which are arranged in annular
or serpiginous pattern with raised edge and central plug. These are more commonly distributed over
back, sides of neck and extremities in bilateral symmetrical pattern. It is common in age group of
5 to 20 years with male predominance. Lesions are generally self limiting in nature. Isotretinoin is
used in penicillamine induced disease. A 45 year old diabetic female presented with chief complaints
of asymptomatic dark coloured raised lesions on face, sides of neck and upper extremities in bilateral
symmetrical pattern for last four years. On cutaneous examination multiple asymptomatic hyperpigmented
keratotic papular lesions, coalescing to form plaques were arranged in annular, serpiginous and polycyclic
pattern over face, sides of neck, chest and forearms distributed in bilaterally symmetrical pattern with
central sparing and atrophy. Patient underwent general and systemic examination followed by routine and
histopathological examination. Routine investigations were normal except random blood sugar and HBA1C
levels were raised. Histopathological examination revealed hyperkeratotic and acanthotic epidermis with
transepidermal channels having nuclear debris and elastic fibres. Patient was explained about course and
prognosis of disease and was stared on topical and oral retinoids. Later, she was lost follow up.
Keywords: Elastosis perforans serpiginosa, Perforating disorder, Rare.