The Role of Dermoscopy in Diagnosis: A Case Presentation of Pseudoxanthoma Elasticum Initially Misdiagnosed as Pigmented Contact Dermatitis

摘要

A 45-year-old female with a three-year history of bilateral ocular angioid streaks was referred to our dermatology department Kırşehir Ahi Evran University for the evaluation of persistent cutaneous lesions, present since childhood (Figure 1, A–D). The patient was previously diagnosed with pigmented contact dermatitis 5 years ago, in a different dermatology outpatient clinic. Dermatological examination in our dermatology department showed confluent yellowish papules on both sides of the neck (Figure 2A). Dermoscopic examination revealed reticulated yellow-to-white clods on a light red background, along with defocused linear irregular vessels (Figure 2B). Histopathological examination showed mild epidermal atrophy, accumulation of swollen clumped fibers, mild inflammatory cell infiltration, and dilated dermal vessels (Figure 2C). Elastic van Gieson staining showed fragmented elastic fibers. Based on the clinical, dermoscopic and histopathological features, a diagnosis of pseudoxanthoma elasticum was made. Detailed imaging studies showed no systemic involvement except for ocular lesions.