ELASTODERMA
Description
🔹 Definition:
# Elastoderma is a localized skin disorder marked by an aberrant buildup and looseness of dermal elastic fibers.
# It causes concentrated patches of loose, redundant, and drooping skin that are more locally distributed and frequently resemble cutis laxa.
🔹 Epidemiology:
# Only uncommon; only few cases have been documented globally. Both sexes are affected; there is no clear gender preference.
# Although pediatric and adult cases have been reported, it typically manifests in adolescent or early adulthood.
🔹Pathophysiology & Etiology:
# Although the precise reason is uncertain, a number of mechanisms have been suggested; Elastin metabolism is abnormal, characterized by either excessive production or defective breakdown. Disorganized or excessive elastic tissue is the result of fibroblast dysfunction.
# Like elastofibroma, it can be a localized form of elastosis. Reactive elastogenesis may be the cause of some cases that have been documented following inflammation or trauma.
🔹Clinical Characteristics :
The primary symptom is a small area of sagging, loose skin that is not irritated or sensitive.
Distribution: Usually impacts the upper extremities, trunk, axillae, or neck. Usually localized and unilateral.
Skin may show up as pendulous, soft, wrinkled, and redundant.
In contrast to widespread cutis laxa, it is not linked to systemic characteristics.
The lesions are slow-growing and persistent.
🔹 Histopathology:
A biopsy reveals a significant buildup of elastic fibers in the dermis.
Elastic tissue exhibits aberrant clustering, thickening, and fragmentation.
In most cases, collagen is normal.
Staining (such as Orcein or Verhoeff-Van Gieson) draws attention to aberrant elastic fibers.
🔹 Differential Diagnosis:
# Cutis laxa → widespread skin laxity, frequently involving the entire body.
# Anetoderma → loss of elastic fibers and localized skin laxity (opposite process).
# Selective loss of middermal elastic fibers due to middermal elastolysis. #Pseudoxanthoma elasticum: calcified elastic fibers associated with a systemic illness.
🔹 Treatment:
# No particular medical intervention is known.
#Recurrence is probable, however surgical excision of superfluous skin may enhance look.
# The two primary strategies are cosmetic correction and supportive management.
# The prognosis is generally good because there are no systemic problems.
🔹 Prognosis:
=Cosmetically distressing but benign disorder.
=Lesions often last a long period and may progress gradually.
=No systemic danger or malignant change.
🔹Elastoderma Case Report :
# Patient: white male 16 years old
# History:
The anterior neck began to wrinkle and exhibit growing skin laxity and extensibility.
Onset after an incident of folliculitis .
The lesion developed over four months and then stayed steady for two years.
No family history of comparable skin alterations
# Clinical Results:
Localized lesion: around 5 cm in diameter and confined .
Features of the skin: wrinkled, supple, and extensible .
Location: the neck's anterior aspect Unusual suppleness is confirmed by stretching the afflicted skin.
Protocol
🔹Challenges for Nurses in Elastoderma:
1. Physical Care Issues:
In deep folds, skin laxity can cause friction and folding, which raises the risk of irritation, fungus infection, or poor cleanliness.
Patients recovering from surgery need wound care and infection control. mobility and positioning issues in extreme situations.
2. Emotional and Psychological Problems:
The patient may experience self-consciousness as a result of obvious skin changes.
Possible symptoms include social disengagement, despair, or anxiety. If patients are discouraged with the cosmetic results, nurses may experience non-adherence to follow-up.
3. Patient Education Challenges: Due to the rarity of the illness, patients and their family frequently don't know about it.
In easy language, nurses must describe the condition's benign yet persistent nature.
Misconceptions can lead to needless anxiety, such as the concern that it will spread or develop into cancer.
4. Holistic Care Burden: Psychosocial, aesthetic, and restorative requirements must be attended to by nurses.
Families may become frustrated when they demand a "complete cure," which is impossible.
🔹 Elastoderma Nursing Management:
1. Skin Care Management:
To avoid bacterial or fungal infections, keep skin folds dry and clean.
Use emollients to keep your skin hydrated.
To lessen friction, promote wearing loose, breathable clothing.
2. Postoperative Nursing:
Keep an eye out for dehiscence, infection, or delayed healing of the wound.
Provide appropriate clothing changes and pain treatment.
Inform the patient and their family about scar care and the potential for recurrence.
3. Psychological and Emotional Support:
Offer guidance and assurance about the benign character.
Provide emotional support and promote candid conversations on issues related to one's self-image. Refer people to support groups or mental health specialists if necessary.
4. Patient and Family Education: Explain that elastoderma is a chronic condition that does not pose a threat to life.
Emphasize the value of routine dermatological checkups.
Describe how surgery might enhance one's appearance, but that recurrence is a possibility.
5. Rehabilitation & Lifestyle Advice: If big folds make it difficult to move, suggest light workouts to keep your range of motion.
Advice on how to choose comfortable and self-assured adaptable apparel.
Give dietary guidance to promote healthy skin.
Notes
https://doi.org/10.1016/j.jaad.2005.01.005