DDx
Diagnostic Considerations
Also consider the following:
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Dermatophytosis
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Perforating collagenosis
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Perforating granuloma annulare
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Hypopigmented and somewhat atrophic skin behind a row of advancing papules (has been mistaken for vitiligo by experienced clinicians)
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Acquired perforating dermatosis
Media Gallery
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Elastosis perforans serpiginosa in an arciform pattern on nape of neck.
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Advancing serpiginous arrangement of elastosis perforans serpiginosa papules with mild scarring in their wake.
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Histologic section of elastosis perforans serpiginosa stained with hematoxylin and eosin. Connective tissue fibers and cellular debris are extruded through the epidermis via a spiraling path.
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Cross-section of a nidus of fibers and debris of elastosis perforans serpiginosa in transit through the epidermis, stained with hematoxylin and eosin. Elastic fibers are red.
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Connective tissue and debris of elastosis perforans serpiginosa emerging through the epidermis toward the surface, and elastic fibers in the nearby papillary dermis. The stain is a variation on acid orcein-Giemsa. Elastic fibers are black.
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