FIBROELASTOLYTIC PATTERNS OF INTRINSIC SKIN AGING - PSEUDOXANTHOMA-ELASTICUM-LIKE PAPILLARY DERMAL ELASTOLYSIS AND WHITE FIBROUS PAPULOSIS OF THE NECK

Background: Cutaneous aging is due to intrinsic and extrinsic factors. While the pathologic hallmark of extrinsic aging (photoaging) is sola r elastosis, intrinsic aging lacks any specific feature. Only a progre ssive thinning and loss of the dermal elastic network occasionally ass ociated with focal thickening of the collagen bundles may be observed. In contrast to the different clinical patterns of solar elastosis, on ly one distinctive disorder has been related so far to intrinsic aging : the temporary wrinkles. Objective: Pseudoxanthoma-elasticum-like pap illary dermal elastolysis (PDE) and white fibrous papulosis of the nec k (WFP) are further clinicopathologic patterns of intrinsic aging. Mat erial and Methods: Review of the literature and clinical and histologi c studies of patients of our files. Results: PDE and WFP share some pe culiar clinical and histologic features, namely their occurrence in la te adulthood and thinning or loss of the elastic fibers, mainly in the papillary dermis. Moreover, elastolysis in PDE and focal fibrosis in WFP, along with the abnormal elastic fibers, immature elastogenesis an d activation of fibroblasts observed in PDE, are quite similar to the changes described in intrinsic aging. Conclusions: PDE and WFP along w ith temporary wrinkles and some cases of noninflammatory middermal ela stolysis could be classified as 'age-related fibroelastolytic syndrome s'.