Elastosis L94.83

Clinical and histological term for a congenital or acquired degeneration of the collagenous connective tissue in the corium. The elastotic material (see Elastosis actinica) behaves "staining technically" like the elastic fibres of the skin (hence the artificial name "elastotic").

Damaging external and internal mechanisms are discussed.

External: Physical influences such as UV rays, X-rays, exposure to light sensitizing substances such as tar products.

Internal/external: Harmful metabolites that induce elastosis in conjunction with UV rays (e.g. porphyrins; dialysis; alcohol; nicotine).

Occurrence has been described in clinical pictures such as pseudoxanthoma elasticum, chronic UV damage, actinic elastosis, Landmann's skin, X-ray elastosis, tar skin, porphyria cutanea tarda, renal insufficiency, elastoidosis cutanea nodularis et cystica.

Light-exposed skin areas; forehead, nose, cheeks, neck.

Notice. Other areas such as the backs of the hands, forearms and neck region react less with scaly elastosis but with dermal atrophy. An example of this is erythrosis interfollicularis colli.

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Circumscribed, congenital elastotic skin changes are found in pseudoxanthoma elasticum.

Acquired elastosis: Clinically, a coarsened skin relief with pronounced macro-wrinkling appears. The skin is flabby, wrinkled, and coarsely puckered in the light-exposed areas. When the skin is stretched, a yellowish reticular pattern is seen in the dermis. An increase in elastotic deposits leads to the formation of soft, skin-colored to slightly yellowish, cobblestone-like skin patches (see also elastosis actinica). The "elastotic" degeneration of the skin leads to a loss of elasticity of the skin, to an increased formation of wrinkles, to a widening of the skin pores. This loss of elasticity leads to the clinical picture of elastoidosis cutanea nodularis et cystica in the face (in "weather-tanned people"), especially over the cheekbones.

On the neck, it appears as cutis rhomboidalis nuchae, a particularly coarsely meshed skin field with deep wrinkling.