PMC8138145_01
a Clinical photograph: multiple papules on the lateral aspect of the neck. b Hematoxylin and eosin staining (40x) in the reticular dermis shows medium and short fibers, basophilic, granular, irregularly arranged. c Von Kossa staining: the calcification of the elastic fibers (400x) is evident.
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F1
During physical examination, it was described to be characterized by confluent papules, of 2 to 3 mm approximately, discretely hyperpigmented and asymptomatic (Fig. 1a). In the middle reticular dermis, short, basophilic, granular, and irregularly shaped fibers were observed (Fig. 1b). With staining for elastic fibers, they were shown to be fragmented, and Von Kossa staining evidenced their calcification (Fig. 1c).
PMC8138145_02
a Clinical image of inguinal region and right and left armpits, where loose skin is observed, with yellowish patches, conformed by papules. b In histopathological description with hematoxylin and eosin staining, basophilic material is observed in the middle dermis (40x). c With the staining of elastic fibers, short and fragmented fibers (400x) are observed.
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F2
During physical examination, bilateral symmetrical dermatosis was observed, predominantly in folds, characterized by loose skin, soft texture, and plaques consisting of skin-colored papules 3-4 mm in diameter (Fig. 2a). In the middle reticular dermis, irregularly arranged short basophilic fibers were observed (Fig. 2b). The staining of elastic fibers (Fig. 2c) showed that the fragmented debris corresponded to these fibers and Von Kosa staining showed the presence of calcium inside.
a Fundus photograph of the left eye with mottled hyperpigmentation to the periphery of the temporal zone of the retina and angioid steaks with crystalline spots. b Fundus photograph of the left eye with classic-appearing orange peel and choroidal neovascularization.
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F3
Fundus examination in both eyes revealed classic-appearing angioid streaks with crystalline spots, retinal pigment with epithelial atrophy (peripapillary), and choroidal neovascularization (Fig. 3a, b).