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Images/Instrument in Dermatology/Dermatosurgery
2023
:3;
135
doi:
10.25259/CSDM_171_2023

Pseudoxanthoma elasticum and angioid streaks

Department of Dermatology, Jawaharlal Institute of Postgraduate Medical Education and Research, Puducherry, India
Department of Dermatology, Jawaharlal Institute of Postgraduate Medical Education and Research, Puducherry, India
Department of Ophthalmology, Jawaharlal Institute of Postgraduate Medical Education and Research, Puducherry, India
Corresponding author: Logamoorthy Ramamoorthy, Department of Dermatology, Jawaharlal Institute of Postgraduate Medical Education and Research, Puducherry, India. logamoorthy.r@gmail.com
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This is an open-access article distributed under the terms of the Creative Commons Attribution-Non Commercial-Share Alike 4.0 License, which allows others to remix, transform, and build upon the work non-commercially, as long as the author is credited and the new creations are licensed under the identical terms.

How to cite this article: Ramamoorthy L, Rout N, Kaur A. Pseudoxanthoma elasticum and angioid streaks. CosmoDerma 2023;3:135.

A 33-year-old male known case of pseudoxanthoma elasticum complained of increased skin lesions over the neck and axilla for the past 3 years. There was no family history of similar complaints. Cutaneous examination showed multiple, discrete-to-confluent, yellowish, flat-topped papules with a cobblestone-like appearance distributed symmetrically over the neck and bilateral axilla [Figure 1]. The rest of the physical examination was found to be normal. Ocular examination on fundoscopy showed a peau d’orange appearance, comet tail lesions, and angioid streaks [Figure 2].

Figure 1:
(a-c) Cutaneous examination shows numerous firm, round-to-oval, yellowish, non-follicular papules of a few millimeters in diameter, coalescing into plaques with a symmetric disposition around the neck and bilateral axilla.
Figure 2:
A dilated fundoscopy examination of both eyes shows multiple hyperpigmented narrow irregular lines deep to the retina in a radiating fashion emanating from the disc suggestive of angioid streaks (red arrow) with comet-tail lesions seen in the mid periphery (blue arrow), there is presence of pebbly orange or peau d’orange appearance of retina temporal to macula (yellow circle).

Angioid streaks are the most common eye findings in pseudoxanthoma elasticum and have been reported in 59–87% of the cases. They are asymptomatic, but when it extends into the foveola, it leads to loss of visual acuity. It can also cause irreversible vision loss due to rupture of the Bruch’s membrane, subretinal hemorrhages, and macular neovascularization.[1] This case highlights that ophthalmological examination is essential for patients without ocular symptoms and counseling about systemic complications and regular follow-up.

Declaration of patient consent

The authors certify that they have obtained all appropriate patient consent.

Conflicts of interest

There are no conflicts of interest.

Use of artificial intelligence (AI)-assisted technology for manuscript preparation

The authors confirm that there was no use of artificial intelligence (AI)-assisted technology for assisting in the writing or editing of the manuscript and no images were manipulated using AI.

Financial support and sponsorship

Nil.

References

  1. , , . Pseudoxanthoma elasticum and angioid streaks. QJM. 2021;114:274.
    [CrossRef] [PubMed] [Google Scholar]

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