Atrophy of the skin (overview)

Author: Prof. Dr. med. Peter Altmeyer

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Last updated on: 29.10.2020

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Synonym(s)

atrophy of the skin; Skin atrophy

History
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Clinical classification of skin and/or subcutaneous atrophy:

Definition
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Atrophy of the skin (e.g. in an atrophic scar) is a loss of substance of the skin, combined with characteristic structural changes of the collagen fibre texture (reduction of collagen fibre bundles) and shrinking of the tissue. In atrophy of the skin, the skin is circumscribed or diffusely reduced in its consistency with simultaneous loss of elasticity. The atrophy of the skin can affect individual layers:

  • Atrophy of the epidermis is manifested as thinning and cigarette-paper-like wrinkling
  • atrophy of the dermis shows itself as a flat depression of the surface or thinning of lifted skin folds
  • the atrophy of the fatty tissue shows itself as a trough-shaped or extensive depression of the skin surface.

If the atrophy affects all three layers of the skin (epidermis, dermis, subcutis), the main clinical feature is the change in the skin. The atrophic skin is smoother and can be folded like cigarette paper. The finer surface relief is missing. The skin is more transparent, allowing the enclosed or underlying components (e.g. larger vessels) to shimmer through. In the striae cutis distensae, the atrophy of the skin affects the epidermis and dermis in stripes, especially the elastic fibres. The subcutaneous fatty tissue can also disappear in isolation, e.g. when panniculitis melts or after injections of glucocorticoids. Atrophy of the entire skin (and the underlying fatty and muscle tissue) is found in various panatrophies, e.g. in aplasia cutis.

Classification
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Clinical classification of atrophy of the skin and/or subcutis:

Literature
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  1. Altmeyer P (2007) Dermatological differential diagnosis. The way to clinical diagnosis. Springer Medicine Publishing House, Heidelberg

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Last updated on: 29.10.2020