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Arch Dermatol. 2005;141:1457-1462.

	Since this article does not have an abstract, we have provided the first 150 words of the full text and any section headings.

Diagnosis: Elastosis perforans serpiginosa (EPS).

MICROSCOPIC FINDINGS AND CLINICAL COURSE

Microscopic examination (Figure 3) revealed epidermal acanthosis and an epidermal invagination containing both parakeratotic crust and degenerated material. A giant cell inflammatory reaction was noted in the underlying dermis. Staining with Sel-Giemsa (Figure 4) confirmed the presence of multiple elastic fibers both within the degenerated material of the epidermal invagination and in the dermis. On the basis of the clinical and microscopic findings, a diagnosis of penicillamine-induced EPS was made. Penicillamine therapy was discontinued, and treatment with zinc acetate was initiated to control Wilson disease. The skin lesions persisted despite trials of liquid nitrogen, intralesional triamcinolone, carbon dioxide laser, and pulsed dye laser therapy. After several months of treatment with isotretinoin, however, the patient showed marked improvement. Her condition has been controlled with this regimen without recurrence for more than 2 years.

Figure appears in full text version. Figure 3.

Figure appears in full text version. Figure 4.

DISCUSSION

Elastosis perforans serpiginosa is a classic perforating dermatosis.^1-2 It is . . . [Full Text of this Article]

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Arch Dermatol. 2005;141(11):1457-1462.
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