Indian Journal of Dermatology
CORRESPONDENCE COLUMN
Year
: 2007  |  Volume : 52  |  Issue : 1  |  Page : 66--67

Linear focal elastosis (elastotic striae)


KN Shivaswamy, Aravind Babu, Devinder Mohan Thappa 
 Department of Dermatology and STD, JIPMER, Pondicherry - 605 006, India

Correspondence Address:
Devinder Mohan Thappa
Department of Dermatology and STD, JIPMER, Pondicherry - 605 006
India




How to cite this article:
Shivaswamy K N, Babu A, Thappa DM. Linear focal elastosis (elastotic striae).Indian J Dermatol 2007;52:66-67


How to cite this URL:
Shivaswamy K N, Babu A, Thappa DM. Linear focal elastosis (elastotic striae). Indian J Dermatol [serial online] 2007 [cited 2020 Dec 1 ];52:66-67
Available from: https://www.e-ijd.org/text.asp?2007/52/1/66/31933


Full Text

A 16-year-old male came to our dermatology OPD with asymptomatic skin lesions over back of one year duration. The lesions started as small horizontal streaky lines over lower back to begin with and spread to involve mid back also. There was no history of sudden weight gain, steroid or hormonal therapy or exercise. He had no history of similar disorder in the family members and similar lesions elsewhere in the body including shoulder or pelvic girdle.

On physical examination, there were multiple horizontal skin coloured to yellowish, slightly raised, transverse streaky bands of varying length from 2 cm to more than 10 cm spread across the midline over mid and lower back [Figure 1]. With the above clinical findings, a diagnosis of linear focal elastosis was made.

Histopathological examination from one of the transverse streaks from the lower back revealed increased elastic fibers in the dermis. These elastic fibers were thin, wavy, elongated as well as fragmented and clumped [Figure 2]. These histological findings were consistent with our clinical diagnosis of linear focal elastosis.

Linear focal elastosis (LFE) also called elastotic striae is relatively a rare disorder characterized by asymptomatic palpable skin coloured to yellowish transverse streak like yellowish lines seen usually over mid and lower black.[1] Burket el al[2] was the first to describe this condition in three elderly men. Later many reports of linear focal elastosis have been described in both young men and women, including a case of linear focal elastosis in a 13-year-old girl over the legs by Brier et al .[3]

The exact pathogenesis of this condition is still unclear, both degeneration and elastogenesis or regeneration has been described in lesions of LFE. Currently, degeneration and regeneration of elastic fiber is thought to be a possible pathomechanism.[4]

Clinically, these lesions are characterized by skin coloured to yellowish slightly palpable transverse streaks, spread across the midline over mid and lower back. These lesions have to be differentiated from striae distensae. The striae distensae are depressed rather than elevated and are pink or white in colour and are usually associated with history of sudden weight gain, hormonal or steroid application or exercise. They are usually located over the abdomen, thighs, arms or breast. Histology of striae shows altered collagen bundles without any changes in elastic tissue.[1],[2],[5] In contrast, there is increased number of elastic fibers in the dermis in lineal focal elastosis. These fibers are thin, elongated, wavy, fragmented and clumped. Electron microscopy reveals elongated, irregularly-shaped swollen elastic fibers with degenerative changes.[2],[6] Other histological differential diagnoses include pseudoxanthoma elasticum, where stain for calcium such as von Kossa is positive and solar elastotic bands, where there will be a nodular aggregation of elastotic material in the upper dermis that are divided by cleft-like spaces.[2]

References

1Odom RB, James WD, Berger TG. Andrew's diseases of the skin, 9th ed. WB Saunders: Philadelphia; 2000. p. 636-47.
2Burket JM, Zelickson AS. Padilla RS. Linear focal elastosis (elastotic striae). J Am Acad Dermatol 1989;20:633-6.
3Breier F, Trautinger, Jurecka W. Honigsmann H. Linear focal elastosis (elastotic striae): Increased number of elastic fibres determined by a video measuring system. Br J Dermatol 1997;137:955-7.
4Choi SW, Lee JH, Woo HJ, Park CJ, Yi JY, Song KY, et al . Two cases of linear focal elastosis: Different histopathologic findings. Int J Dermatol 2000;39:207-9.
5Tamada Y, Yokochi K, Ikeya T, Nakagomi Y, Miyake T, Hara K. Linear focal elastosis: A68 review of 3 cases in young Japanese men. J Am Acad Dermatol 1997;36:301-3.
6Vogel PS, Cardenas A, Rose EV, Cobb MW, Sau P, James WD. Linear focal elastosis. Arch Dermatol 1995;131:855-6.