Linear focal elastosis (LFE), also known as elastotic striae, is an abnormality of elastic tissue that presents with palpable, indurated, or atrophic linear plaques that have a yellowish hue. Lesions are asymptomatic and tend to develop on the middle or lower back, upper and lower extremities, and breasts.
This condition predominates in men, usually elderly men, on their backs. However, reports of cases occurring in younger individuals point to the possibility that LFE is more common in younger populations than previously thought.
The pathogenesis of LFE is unknown. Various theories have been proposed, including that LFE represents a degenerative or regenerative process of striae distensae or that the condition may represent a nevoid or hamartomatous condition of degenerative or regenerative processes occurring in elastic fibers. It is not uncommon for lesions of LFE to occur in association with striae distensae. In such cases, blunt trauma, growth spurt, weight loss, pregnancy, rigorous exercise routine, and potent topical steroid application are reported as trigger factors.
Four cases of LFE with a positive family history have been reported thus far; however, the involvement of genetic factors is still unclear.
Linear focal elastosis
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Synopsis
Codes
ICD10CM:
L94.9 – Localized connective tissue disorder, unspecified
SNOMEDCT:
773697006 – Linear focal elastosis
L94.9 – Localized connective tissue disorder, unspecified
SNOMEDCT:
773697006 – Linear focal elastosis
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Differential Diagnosis & Pitfalls
Clinical Differential Diagnosis:
Histopathologic Differential Diagnosis:
Histopathologic Differential Diagnosis:
- Dermatofibrosis lenticularis disseminata (collagenoma) – Presents as grouped, yellow to skin-colored papules that may form plaques, typically in a child; histologically features dermal collagen-predominant lesions; may be associated with Buschke-Ollendorff syndrome.
- Elastoma – Presents as firm and yellow papules and plaques, typically before puberty; biopsy shows a focal increase in normal-appearing elastic tissue in the mid and lower dermis; may be associated with Buschke-Ollendorff syndrome.
- Pseudoxanthoma elasticum – Presents as yellowish papules coalescing into cobblestone-like plaques in flexural regions; often has systemic involvement; histology is characterized by calcified elastic fibers.
- Fibroelastolytic papulosis – Presents as whitish-yellow papules and plaques on the neck, typically in an older patient; histology shows elastolysis and fibrosis of the upper reticular and papillary dermis.
- Late-onset focal dermal elastosis – Is age-dependent and presents with yellow papules, typically on the sides of the neck and flexural areas; in histology, thick, interlacing elastic fibers are seen in the upper and mid dermis.
- Solar elastosis – Has a photodistribution pattern; presents with gray to yellow, telangiectatic, thickened or atrophic wrinkles; other signs of photoaging may be present; histology shows amorphous elastic bands in the dermis.
- Elastoderma – Characterized by localized skin laxity and increased elastic tissue.
- Mid-dermal elastolysis – Presents as thin, superficial, wrinkled plaques due to loss of elastic tissue.
- Elastosis perforans serpiginosa – Presents with hyperkeratotic papules / plaques; histology shows transepidermal elimination of elastic fibers.
- Anetoderma – Characterized by loss of elastic fibers.
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Last Reviewed:07/19/2020
Last Updated:07/20/2020
Last Updated:07/20/2020
Linear focal elastosis