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Elastoderma

Table of Contents

Elastoderma

Elastic Skin; Hyperextensible Skin; Skin Hyperelasticity

Elastoderma is a rare skin condition where people affected have increased laxity of skin covering a specific area of the body. This skin hangs in loose folds and is not stretchy. While any area can be affected, the skin of the neck, elbows, and/or knees are most commonly involved. Learn more about elastoderma, including its causes and treatments.

Chest skin and light

Image by Elements Of This World/Wikimedia

About

Epidermis (skin)

Image by Source:National Cancer Institute, Don Bliss (Illustrator)

Epidermis (skin)

The layers of the skin (epidermis and dermis), as well as an inset with a close-up view of the types of cells in the skin (squamous cells, basal cells, and melanocytes).

Image by Source:National Cancer Institute, Don Bliss (Illustrator)

What Is Elastoderma?

Elastoderma is a rare condition that affects the skin. People affected by elastoderma generally have increased laxity of skin covering a specific area of the body. Decreased recoil of the skin has also been reported. Although any part of the body can be affected, the skin of the neck and extremities (arms and legs, especially at the elbows and/or knees) are most commonly involved. The exact underlying cause is currently unknown; however, it generally occurs sporadically in people with no family history of the condition. There is no standard therapy available for elastoderma. Some cases have been treated with surgical excision (removal of affected skin), but hyperlaxity of skin often returns following the surgery.

Source: Genetic and Rare Diseases (GARD) Information Center

Causes

Idiopathic - Unknown

Image by PaliGraficas/Pixabay

Idiopathic - Unknown

Image by PaliGraficas/Pixabay

What Causes Elastoderma?

The exact underlying cause of elastoderma is currently unknown. It is thought to occur when there is an over-production of elastin in a specific area of skin. Elastin is a protein that is a vital component of skin and other connective tissues throughout the body. It serves many roles. For example, elastin provides strength and flexibility to connective tissues; give structural support to organs and tissues such as the heart, skin, and lungs; and helps the skin return to its original position when it is poked or pinched (recoil). It is unclear what causes this increase in elastin synthesis in people affected by elastoderma.

Source: Genetic and Rare Diseases (GARD) Information Center

Symptoms

Elastic Skin

Image by Couch-scratching-cats/Wikimedia

Elastic Skin

Elastic skin shown in the belly of a toddler, possibly caused by Ehlers Danlos Syndrome

Image by Couch-scratching-cats/Wikimedia

What Are the Signs and Symptoms of Elastoderma?

Although any part of the body can be affected, the skin of the neck and extremities (arms and legs, especially at the elbows and/or knees) are most commonly involved.

Source: Genetic and Rare Diseases (GARD) Information Center

Additional Materials (3)

Hyperextension Skin Hand

Image by Dagger9977

Skin hyperelasticity in the neck

Image by Rollcloud/Wikimedia

Skin model

A model of human skin. Fat cells from the hypodermis are given in blue. Blood vessels in red, nerve tissue in green and hairs, associated glands and other glands in yellow. Connective tissue of hypodermis and dermis is given in brown. The epidermis on top is given in red/pink colour. The picture is part of a short film on skin composition at https://library.storymd.com/search/videos?term=Skin+architecture

Image by Scivit

Hyperextension Skin Hand

Dagger9977

Skin hyperelasticity in the neck

Rollcloud/Wikimedia

Skin model

Scivit

Diagnosis

An illustration depicting the skin punch biopsy.

Image by BruceBlaus

An illustration depicting the skin punch biopsy.

An illustration depicting the skin punch biopsy.

Image by BruceBlaus

How Is Elastoderma Diagnosed?

A diagnosis of elastoderma is generally made in people with characteristic signs and symptoms once other conditions that cause similar features have been ruled out. A skin biopsy may be recommended to confirm the diagnosis.

Source: Genetic and Rare Diseases (GARD) Information Center

Additional Materials (1)

Punch biopsy

Skin biopsy

Image by Brimstone

Punch biopsy

Brimstone

Skin Biopsy

Skin Biopsy

Also called: Skin Lesion Biopsy

A skin biopsy is a procedure that removes a small sample of skin for testing. Skin biopsies are used to check for skin cancer, skin infections, or skin disorders, such as psoriasis.

Skin Biopsy

Also called: Skin Lesion Biopsy

A skin biopsy is a procedure that removes a small sample of skin for testing. Skin biopsies are used to check for skin cancer, skin infections, or skin disorders, such as psoriasis.

{"label":"Skin Biopsy Reference Range","scale":"lin","step":0.25,"hideunits":true,"items":[{"flag":"normal","label":{"short":"Normal","long":"Normal","orientation":"horizontal"},"values":{"min":0,"max":1},"text":"If your results are normal, it means no cancer or skin disease was found. If a skin lesion is benign (not cancer), you may not need any further treatment.","conditions":[]},{"flag":"abnormal","label":{"short":"Abnormal","long":"Abnormal","orientation":"horizontal"},"values":{"min":1,"max":2},"text":"Once the biopsy confirms the diagnosis, your provider will start a treatment plan.","conditions":["Bacterial or fungal infection","Psoriasis or dermatitis","Melanoma","Basal cell skin cancer","Squamous cell skin cancer"]}],"value":0.5}[{"normal":0},{"abnormal":0}]
Use the slider below to see how your results affect your health.
Your result is Normal.
If your results are normal, it means no cancer or skin disease was found. If a skin lesion is benign (not cancer), you may not need any further treatment.
Related conditions
A skin biopsy is a procedure that removes a small sample of skin for testing. The procedure can help diagnose a skin lesion (an abnormal area of skin). The skin sample is looked at under a microscope to check for skin cancer, a variety of skin conditions, or skin infections. Only certain skin lesions need a biopsy. Your provider may be able to diagnose many types of lesions just by looking at them.
There are three main ways to do a skin biopsy. The type of biopsy you have depends on the location, size, and depth of the skin lesion:
- A shave biopsy removes a sample from the top layers of skin with a razor blade or scalpel (a small cutting blade used for surgery). Your provider will do a shave biopsy if your condition appears to involve only the top layers of skin.
- A punch biopsy uses a special tool with a round blade to remove the skin sample. Your provider will do a punch biopsy if your condition appears to involve the deep layers of skin.
- An excisional biopsy uses a scalpel to remove all of the skin lesion, usually with some normal skin around it. The sample may include the full thickness of the skin along with fat below the skin.
Most skin biopsies can be done in a health care provider's office or other outpatient facility.
A skin biopsy is used to help diagnose a variety of skin conditions including:
- Skin disorders such as psoriasis, eczema, actinic keratosis ("precancers"), and warts.
- Bacterial or fungal infections of the skin.
- Skin cancer. A biopsy can confirm or rule out whether a suspicious mole or other growth is cancer. If the result is cancer, the biopsy can show what type of skin cancer it is.
Skin cancer is the most common type of cancer in the United States. The two most common types of skin cancer are basal cell and squamous cell cancers. These cancers rarely spread to other parts of the body and can usually be cured with treatment. In many cases, the biopsy removes all the cancer, and no other treatment is needed.
The most serious type of skin cancer is melanoma. It's more likely than other skin cancers to spread to other parts of your body, including to your organs. Most deaths from skin cancer are caused by melanoma.
A skin biopsy can help diagnose skin cancer in the early stages, when it's easier to treat.
You may need a skin biopsy if you have certain skin symptoms, such as:
- A rash that doesn't go away
- Scaly or rough skin
- Open sores that won't heal
- A mole or skin growth that has changed in its shape, color, or size
- A mole or new growth that has the "A-B-C-D-Es" of melanoma:
  Asymmetrical - the shape is not regular
  Border - the edge is jagged
  Color - the color is uneven
  Diameter - the size is larger than a pea
  Evolving - the mole or growth has changed in the past few weeks or months
- Blistering skin, which may be a sign of pemphigus, an autoimmune disease
A provider will clean the site and give you an injection (shot) to numb your skin so you won't feel any pain.
For a punch biopsy:
- A provider uses a special tool with a hollow, round blade. The blade is placed over the abnormal skin area (lesion) and rotated to remove a small piece of skin about the size of a pencil eraser.
- The sample is lifted out with another tool.
- If a larger skin sample is taken, you may need one or two stitches to close the wound.
- Pressure will be applied to the wound until the bleeding stops.
- The wound will be covered with a bandage.
A punch biopsy is often used to diagnose rashes.
For a shave biopsy:
- A provider will use a razor or a scalpel to remove a sample from the top layer of your skin.
- To help stop the bleeding, pressure will be applied to the wound, or medicine may be spread over the wound.
- The wound will be covered with a bandage.
A shave biopsy is often used if your provider thinks you may have basal cell or squamous cell skin cancer or if you have a rash appears to affect only the top layer of your skin.
For an excisional biopsy:
- A doctor will use a scalpel to remove the entire skin lesion, usually with some normal skin around it called "a margin." If the skin lesion is large, your provider may remove only a piece of it. This is called an incisional biopsy.
- The doctor will close the wound with stitches.
- Pressure will be applied to wound until the bleeding stops.
- The wound will be covered with a bandage.
An excisional biopsy is often used if your provider thinks you may have melanoma, the most serious type of skin cancer. It may also be used for basal cell and squamous cell skin cancer.
After the biopsy, keep the area covered with a bandage until you've healed or until your stitches come out. If you had stitches, they will be taken out 3-14 days after the biopsy.
1. Skin Biopsy: MedlinePlus Lab Test Information [accessed on Oct 05, 2022]
2. Skin lesion biopsy: MedlinePlus Medical Encyclopedia [accessed on Dec 20, 2018]

Normal reference ranges can vary depending on the laboratory and the method used for testing. You must use the range supplied by the laboratory that performed your test to evaluate whether your results are "within normal limits."

Additional Materials (14)

Punch Biopsy

Empty pilar cyst removed from the scalp of a woman through a small punch biopsy hole through the scalp.

Image by Northerncedar (talk)

Hyperkeratosis

Low magnification micrograph of lichen simplex chronicus. Skin biopsy.

Image by Nephron

Lichen simplex chronicus

Very low magnification micrograph of lichen simplex chronicus, abbreviated LSC. H&E stain. Skin biopsy.Features:

Image by Nephron

Stevens-Johnson syndrome

Very high magnification micrograph of confluent epidermal necrosis. Skin biopsy. H&E stain.

Image by Nephron

Under a medium magnification, this photomicrograph depicts the histopathologic changes seen in human skin biopsy specimen due to Kaposi’s sarcoma. Of importance is the appearance of the dermal layer, which contained a cellular infiltrate, and a proliferation of vascular elements.

Kaposi sarcoma, is a malignant tumor of the lymphatic endothelium caused by the Human herpesvirus 8 (HHV8), i.e., Kaposi’s sarcoma-associated herpesvirus (KSHV), and arises from a cancer of the lymphatic endotheial lining. It is characterized by bluish-red cutaneous nodules. Kaposi’s sarcoma is thought of as an opportunistic infection, affecting patients whose immune systems have been compromised, as in the case of patients with HIV/AIDS.

Image by CDC/ Dr. Peter Drotman

Under a low magnification, this photomicrograph depicts the histopathologic changes seen in human skin biopsy specimen due to Kaposi’s sarcoma. Of importance is the normal appearance of the most superficial epidermal layer on the far left, which was overlying the dermal layer, which contained a cellular infiltrate, and a proliferation of vascular elements.

Kaposi sarcoma, is a malignant tumor of the lymphatic endothelium caused by the Human herpesvirus 8 (HHV8), i.e., Kaposi’s sarcoma-associated herpesvirus (KSHV), and arises from a cancer of the lymphatic endotheial lining. It is characterized by bluish-red cutaneous nodules. Kaposi’s sarcoma is thought of as an opportunistic infection, affecting patients whose immune systems have been compromised, as in the case of patients with HIV/AIDS.

Image by CDC/Dr. Peter Drotman

This photomicrograph of a skin biopsy reveals some cytoarchitectural signs that are indicative of Kaposi's sarcoma.

The dermis contains a dense cellular infiltrate, and narrow slit-like vascular spaces that are characteristic in these KS lesions. KS is a cancer that is common in those who’ve developed the human immunodeficiency virus (HIV), or an AIDS infection.

Image by CDC/ Dr. Steve Kraus

Under medium magnification, this micrograph of a skin biopsy shows the cytoarchitectural changes found in Kaposi's sarcoma.

Note the thinning of the skin layers, most appreciably the dermis, which is reduced in thickness, and flattened due to the presence of a cellular subdermal infiltrate.

Image by CDC/ Dr. Steve Kraus

An illustration depicting the skin punch biopsy.

An illustration depicting the skin punch biopsy.

Image by BruceBlaus

Having a punch biopsy

Video by University Hospitals Birmingham NHS Foundation Trust/YouTube

Biopsy - What You Need To Know

Video by Rehealthify/YouTube

Study examines accuracy of melanoma biopsy findings

Video by UW Medicine/YouTube

What happens to your biopsy?

Video by Sunnybrook Hospital/YouTube

Skin Biopsy for Skin Cancer

Video by Dermatology Office of Dr. Ellen Turner/YouTube

Punch Biopsy

Northerncedar (talk)

Hyperkeratosis

Nephron

Lichen simplex chronicus

Nephron

Stevens-Johnson syndrome

Nephron

Under a medium magnification, this photomicrograph depicts the histopathologic changes seen in human skin biopsy specimen due to Kaposi’s sarcoma. Of importance is the appearance of the dermal layer, which contained a cellular infiltrate, and a proliferation of vascular elements.

CDC/ Dr. Peter Drotman

Under a low magnification, this photomicrograph depicts the histopathologic changes seen in human skin biopsy specimen due to Kaposi’s sarcoma. Of importance is the normal appearance of the most superficial epidermal layer on the far left, which was overlying the dermal layer, which contained a cellular infiltrate, and a proliferation of vascular elements.

CDC/Dr. Peter Drotman

This photomicrograph of a skin biopsy reveals some cytoarchitectural signs that are indicative of Kaposi's sarcoma.

CDC/ Dr. Steve Kraus

Under medium magnification, this micrograph of a skin biopsy shows the cytoarchitectural changes found in Kaposi's sarcoma.

CDC/ Dr. Steve Kraus

An illustration depicting the skin punch biopsy.

BruceBlaus

1:36

Having a punch biopsy

University Hospitals Birmingham NHS Foundation Trust/YouTube

0:47

Biopsy - What You Need To Know

Rehealthify/YouTube

3:13

Study examines accuracy of melanoma biopsy findings

UW Medicine/YouTube

3:26

What happens to your biopsy?

Sunnybrook Hospital/YouTube

0:26

Skin Biopsy for Skin Cancer

Dermatology Office of Dr. Ellen Turner/YouTube

Treatment

Surgery

Image by Staff Sgt. Miguel Lara/Wikimedia

Surgery

U.S. Air Force Maj Jonathan Forbes, 455th Expeditionary Medical Operations Squadron neurosurgeon looks through loupes as he performs brain surgery at the Craig Joint Theater Hospital, Bagram Air Field, Afghanistan, Oct. 10, 2014. The loupes allow Forbes to see the surgery at a two times magnification. Forbes removed an 8-centimeter tumor during the five-hour surgery. Forbes is deployed from Travis Air Force Base, Calif., and is a native of New Martinsville, W.Va. (U.S. Air Force photo by Staff Sgt. Miguel Lara III/Released) Unit: 455th Air Expeditionary Wing

Image by Staff Sgt. Miguel Lara/Wikimedia

How Might Elastoderma Be Treated?

Due to the rarity of the condition, there is no standard therapy available for elastoderma. In some reported cases, the affected skin has been partially excised (removed). However, hyperlaxity of skin often returns following the surgery.

Source: Genetic and Rare Diseases (GARD) Information Center

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Elastoderma

Elastoderma is a rare skin condition where people affected have increased laxity of skin covering a specific area of the body. This skin hangs in loose folds and is not stretchy. While any area can be affected, the skin of the neck, elbows, and/or knees are most commonly involved. Learn more about elastoderma, including its causes and treatments.

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