Anetoderma Workup

  • Author: Anne Elizabeth Laumann, MBChB, MRCP(UK), FAAD; Chief Editor: Dirk M Elston, MD   more...
 
Updated: Sep 12, 2011
 

Laboratory Studies

No blood findings are specific for anetoderma.

Laboratory testing for the presence of thyroid autoantibodies[42] and antiphospholipid antibodies in all patients who present with primary anetoderma is recommended. Antiphospholipid antibody tests include lupus anticoagulant, all isotypes of anticardiolipin, and anti-β2-glycoprotein I antibodies. The following laboratory tests may be considered if clinically indicated:

  • Antinuclear antibody (ANA) test, complement (C3, C4)
  • Other autoantibodies (anti-Ro, anti-La, antimitochondria, anti-smooth muscle)
  • ACE level
  • CBC count
  • Lyme disease titers
  • Purified protein derivative (PPD)
  • Rapid plasma reagin (RPR)/Venereal Disease Research Laboratory (VDRL) test
  • Sedimentation rate
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Histologic Findings

A perivascular and periadnexal lymphohistiocytic infiltrate is seen in the papillary dermis, upper reticular dermis, or both. Marked loss of elastic fibers is observed, although fine microfibrils may remain. Collagen fibers appear normal. Desmosine, a cross-linking compound found only in elastin, is reduced in lesional skin. Early lesions may show a pronounced monocytic infiltrate of predominantly T helper lymphocytes, but occasionally, the predominant cell types are histiocytes, neutrophils, or eosinophils. Scattered macrophages showing elastophagocytosis may be present. Microthromboses may be seen in individuals with anetoderma and antiphospholipid antibodies.

Direct immunofluorescence is usually not helpful, but findings similar to those of lupus erythematosus may be found,[43] with granular deposits of immunoglobulin G (IgG), immunoglobulin M (IgM), and/or complement (C3) along the dermoepidermal junction and blood vessels. Sometimes, fibrillar immunoglobulin and complement deposits are present in the papillary dermis. This probably corresponds to deposition on elastic tissue, although indirect immunofluorescence studies have failed to demonstrate elastic fiber autoantibodies.

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Contributor Information and Disclosures
Author

Anne Elizabeth Laumann, MBChB, MRCP(UK), FAAD  Associate Professor, Department of Dermatology, Northwestern University, The Feinberg School of Medicine

Anne Elizabeth Laumann, MBChB, MRCP(UK), FAAD is a member of the following medical societies: American Academy of Dermatology, Association of Professors of Dermatology, British Association of Dermatologists, Chicago Dermatological Society, Chicago Medical Society, Illinois Dermatological Society, Illinois State Medical Society, Illinois State Medical Society, Medical Dermatology Society, and Society for Investigative Dermatology

Disclosure: Abbott Grant/research funds Other; Regeneron Grant/research funds Other; Centocor Grant/research funds Other; OSI Grant/research funds Other; Celgene Grant/research funds Other; Lilly Grant/research funds Other

Coauthor(s)

Julia Sanger Minocha, MD  Resident Physician, Department of Medicine, Northwestern University, The Feinberg School of Medicine

Julia Sanger Minocha, MD is a member of the following medical societies: Alpha Omega Alpha, American College of Physicians, and Phi Beta Kappa

Disclosure: Nothing to disclose.

Stephen C Ho, MD  Boulder Dermatology Clinic

Stephen C Ho, MD is a member of the following medical societies: American Academy of Dermatology, American Contact Dermatitis Society, American Society for Dermatologic Surgery, American Society for Laser Medicine and Surgery, American Society of Cosmetic Dermatology and Aesthetic Surgery, and Colorado Medical Society

Disclosure: Nothing to disclose.

Specialty Editor Board

Peter Fritsch, MD  Chair, Department of Dermatology and Venereology, University of Innsbruck, Austria

Peter Fritsch, MD is a member of the following medical societies: American Dermatological Association, International Society of Pediatric Dermatology, and Society for Investigative Dermatology

Disclosure: Nothing to disclose.

David F Butler, MD  Professor of Dermatology, Texas A&M University College of Medicine; Chair, Department of Dermatology, Director, Dermatology Residency Training Program, Scott and White Clinic, Northside Clinic

David F Butler, MD is a member of the following medical societies: Alpha Omega Alpha, American Academy of Dermatology, American Medical Association, American Society for Dermatologic Surgery, American Society for MOHS Surgery, Association of Military Dermatologists, and Phi Beta Kappa

Disclosure: Nothing to disclose.

Edward F Chan, MD  Clinical Assistant Professor, Department of Dermatology, University of Pennsylvania School of Medicine

Edward F Chan, MD is a member of the following medical societies: American Academy of Dermatology, American Society of Dermatopathology, and Society for Investigative Dermatology

Disclosure: Nothing to disclose.

Catherine M Quirk, MD  Clinical Assistant Professor, Department of Dermatology, University of Pennsylvania

Catherine M Quirk, MD is a member of the following medical societies: Alpha Omega Alpha and American Academy of Dermatology

Disclosure: Nothing to disclose.

Chief Editor

Dirk M Elston, MD  Director, Ackerman Academy of Dermatopathology, New York

Dirk M Elston, MD is a member of the following medical societies: American Academy of Dermatology

Disclosure: Nothing to disclose.

Acknowledgments

The authors and editors of Medscape Reference gratefully acknowledge the contributions of previous authors, Jenny Sun, MD, and Jin Mo Park, PhD, to the development and writing of this article.

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Multiple lesions of anetoderma.
Close-up view of a single lesion of anetoderma.
 
 
 
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