Overview
Plaque-like CD34 positive dermal fibroma is a rare acquired condition characterized by asymptomatic, nonfollicular papules or plaques, often resembling pseudoxanthoma elasticum (PXE) clinically but lacking systemic implications 1. It primarily affects postmenopausal women, presenting as symmetrical, yellowish or normochromic lesions, predominantly on the neck.Diagnosis
Clinical Presentation: Multiple asymptomatic, nonfollicular papules coalescing into cobblestone plaques, typically symmetrical and located on the neck 1.
Histopathology: Essential for diagnosis; shows loss of elastic plexus in the papillary dermis and presence of melanophages, often with CD34 positivity in dermal fibrotic areas 1.
Differential Diagnosis: Distinguishing from PXE is crucial; histopathology helps differentiate by absence of systemic involvement 1.Management
No Specific Treatment: Primarily managed conservatively due to aesthetic concerns without functional impairment 1.
Patient Education: Informing patients about the benign nature and cosmetic aspects of the condition 1.
Monitoring: Regular follow-up to monitor stability or changes in lesion morphology 1.Special Populations
Postmenopausal Women: Predominantly affects this demographic, warranting specific clinical vigilance 1.
Comorbidities: No specific management adjustments noted for comorbidities; general care guidelines apply 1.Key Recommendations
Histopathological Confirmation: Essential for definitive diagnosis to differentiate from PXE and avoid unnecessary systemic investigations 1 (Evidence: Strong).
Conservative Management: Focus on patient education regarding the benign nature of the condition and monitor for aesthetic concerns 1 (Evidence: Moderate).
Regular Follow-Up: Schedule periodic evaluations to assess stability and address any evolving concerns 1 (Evidence: Expert opinion).References
1 Atzori L, Ferreli C, Pilloni L, Rongioletti F. Pseudoxanthoma elasticum-like papillary dermal elastolysis: A mimicker of genetic pseudoxanthoma elasticum. Clinics in dermatology 2021. link