Treatment of Elastosis Perforans Serpiginosa with the 585-nm Pulsed-dye Laser

23^rd World Dermatology Congress

June 20-21, 2022 | Paris, France

Yeon Gu Choi

Sungkyunkwan University, South Korea

Posters & Accepted Abstracts: J Dermatol Dis

Abstract :

Elastosis perforans serpiginosa (EPS) is a rare disorder showing erythematous or skin-colored hyperkeratotic papules with a serpiginous or arcuate distribution. EPS classified as a primary perforating dermatosis and characterized by transepidermal elimination of abnormal elastic fibers with transepidermal perforating canals from dermis. Among various treatment modalities, standard treatment method has not been established. We report a 33-year-old male patient with a 2-month history of grouped, multiple, annular-shaped, scaly erythematous papules (about 2 to 4 mm in size) on his right anterior neck. Dermoscopy of the plaques revealed central whitish structureless scar-like areas with a polymorphous vasculatures and irregularly arranged multiple keratotic yellowish papules. Histopathological analysis revealed increased brightly eosinophilic elastic fibers from the papillary dermis through the epidermis and clutch the dermis at the site of perforation of elastic fiber. Basophilic mass comprising degenerate epithelial cells, inflammatory debris was also seen. Immunohistochemical analysis revealed degenerated dermal elastic fibers with elastic fiber stain and negative on Periodic acid-Schiff (PAS) and Masson’s trichrome stain. Based on these clinical, dermoscopic, and histological features, the lesion was diagnosed as EPS. After treatment with six session of the 585-nm pulsed-dye laser per 3 weeks, the lesion was cleared without any adverse events associated with laser treatment and no recurrence was observed for 2 months after therapy.