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Introduction: There is an overlap between clinical and pathological features of the entities known as pseudoxanthoma elasticum-like papillary dermal elastolysis (PXE-PDE) and white fibrous papulosis of the neck (WFPN). Although the term fibroelastolytic papulosis has been used to encompass both entities as spectrum variants of a one and only disease, many authors still differentiate the two. Methods: Cases of fibroelastolytic papulosis confirmed by histopathologic examination were retrospectively reviewed within a time frame of 2.5 years. Results: Five cases of fibroelastolytic papulosis were identified. All patients were females aged between 63 and 78 years, presenting with an asymptomatic eruption of isolated or coalescing white to yellow papules on the neck. Two of the patients also had involvement of other anatomical areas. In all cases histology demonstrated a significantly decreased or absent papillary dermal elastic plexus, a mild superficial perivascular lymphocytic infiltrate and sparse melanophages in the papillary dermis, without interface changes. A decrease in upper reticular dermal elastic fibers was noted in four cases and thickening of dermal collagen bundles in three cases. Dilated superficial dermal vessels were present in 3 cases and mild epidermal atrophy in one case. Conclusion: We find the differentiation of PXE-PDE and WFPN to be somewhat theoretical, often confusing, and based on non-significant subtle histological and clinical differences. In our opinion, we should not continue to use these terms, but favor the common term of fibroelastolytic papulosis. [ABSTRACT FROM AUTHOR]

A elastólise da derme papilar semelhante a pseudoxantoma elástico (EDP-PXE) é uma entidade clinico- -patológica adquirida, de etiologia desconhecida, caracterizada por ausência parcial ou total de fibras elásticas na derme superficial. Reportamos o caso clínico de uma doente caucasiana de 62 anos, fototipo III, com uma dermatose localizada nas regiões posterior e laterais do pescoço caracterizada por múltiplas pápulas amareladas, monomórficas, arredondadas, com 2-3mm de diâmetro, assintomáticas, presentes desde há cerca de 2 anos. O exame histopatológico, com a coloração de orceína, revelou ausência quase total de fibras elásticas na derme superficial, compatível com o diagnóstico de EDP-PXE. Consideramos que esta entidade, exclusivamente cutânea, está sub-diagnosticada por se tratar de uma patologia assintomática, cujo diagnóstico histopatológico está dificultado, na ausência de corretas hipóteses de diagnóstico.