- Taraneh Paravar, MD
Taraneh Paravar, MD
- Assistant Professor, Department of Dermatology
- University of California, San Diego
Anetoderma, also known as macular atrophy, is an uncommon disorder of elastic tissue that is clinically characterized by wrinkled and atrophic depressions or saccular outpouchings of the skin (picture 1A-C). The saccular outpouchings may herniate upon digital pressure. The primary histologic finding is the loss of elastic tissue in the dermis.
Anetoderma is divided into primary anetoderma and secondary anetoderma, with the former occurring in areas of previously normal skin and the latter developing in areas of prior skin pathology. Primary anetoderma may occur in association with underlying systemic conditions and warrants evaluation for associated disorders. There is no effective treatment for anetoderma.
The clinical manifestations, diagnosis, and management of anetoderma will be reviewed here. Anetoderma is distinct from atrophoderma of Pasini and Pierini, a disorder characterized by dermal atrophy and well-defined, hyperpigmented, depressed areas of skin. Atrophoderma of Pasini and Pierini is reviewed separately. (See "Atrophoderma of Pasini and Pierini".)
Anetoderma is considered uncommon; however epidemiologic data are limited. The exact prevalence is not known.
Primary anetoderma tends to present between ages 20 to 40 but may occur at both younger and older ages. There seems to be a female predominance in primary anetoderma.To continue reading this article, you must log in with your personal, hospital, or group practice subscription. For more information on subscription options, click below on the option that best describes you:
- Kineston DP, Xia Y, Turiansky GW. Anetoderma: a case report and review of the literature. Cutis 2008; 81:501.
- Aghaei S, Sodaifi M, Aslani FS, Mazharinia N. An unusual presentation of anetoderma: a case report. BMC Dermatol 2004; 4:9.
- Yu HJ, Shin H, Kang MS, Kim JS. A case of primary anetoderma in an infant. Br J Dermatol 2007; 157:1267.
- Emer J, Roberts D, Sidhu H, et al. Generalized Anetoderma after Intravenous Penicillin Therapy for Secondary Syphilis in an HIV Patient. J Clin Aesthet Dermatol 2013; 6:23.
- Staiger H, Saposnik M, Spiner RE, et al. Primary anetoderma: a cutaneous marker of antiphospholipid antibodies. Skinmed 2011; 9:168.
- Venencie PY, Winkelmann RK, Moore BA. Anetoderma. Clinical findings, associations, and long-term follow-up evaluations. Arch Dermatol 1984; 120:1032.
- Prizant TL, Lucky AW, Frieden IJ, et al. Spontaneous atrophic patches in extremely premature infants. Anetoderma of prematurity. Arch Dermatol 1996; 132:671.
- Venencie PY, Winkelmann RK. Histopathologic findings in anetoderma. Arch Dermatol 1984; 120:1040.
- Romaní J, Pérez F, Llobet M, et al. Anetoderma associated with antiphospholipid antibodies: case report and review of the literature. J Eur Acad Dermatol Venereol 2001; 15:175.
- Stephansson EA, Niemi KM, Jouhikainen T, et al. Lupus anticoagulant and the skin. A longterm follow-up study of SLE patients with special reference to histopathological findings. Acta Derm Venereol 1991; 71:416.
- Francès C, Niang S, Laffitte E, et al. Dermatologic manifestations of the antiphospholipid syndrome: two hundred consecutive cases. Arthritis Rheum 2005; 52:1785.
- Yélamos O, Barnadas MA, Díaz C, Puig L. Primary anetoderma associated with primary Sjögren syndrome and anticardiolipin antibodies. Actas Dermosifiliogr 2014; 105:99.
- Hodak E, Feuerman H, Molad Y, et al. Primary anetoderma: a cutaneous sign of antiphospholipid antibodies. Lupus 2003; 12:564.
- Hodak E, Shamai-Lubovitz O, David M, et al. Immunologic abnormalities associated with primary anetoderma. Arch Dermatol 1992; 128:799.
- Sparsa A, Piette JC, Wechsler B, et al. Anetoderma and its prothrombotic abnormalities. J Am Acad Dermatol 2003; 49:1008.
- Clark ER, English JC 3rd. Thrombosis-induced ulcerations of the lower legs with coexistent anetoderma due to anti-thrombin III deficiency. J Am Acad Dermatol 2011; 65:880.
- O'Gorman SM, Sheahan K, Collins P. Cocaine, a culprit in anetoderma? Clin Exp Dermatol 2015; 40:695.
- Bauer J, Leitz G, Palmedo G, Hügel H. Anetoderma: another facet of Lyme disease? J Am Acad Dermatol 2003; 48:S86.
- Lindstrom J, Smith KJ, Skelton HG, et al. Increased anticardiolipin antibodies associated with the development of anetoderma in HIV-1 disease. Military Medical Consortium for the Advancement of Retroviral research (MMCARR). Int J Dermatol 1995; 34:408.
- Hodak E, David M. Primary anetoderma and antiphospholipid antibodies--review of the literature. Clin Rev Allergy Immunol 2007; 32:162.
- Stephansson EA, Niemi KM. Antiphospholipid antibodies and anetoderma: are they associated? Dermatology 1995; 191:204.
- Maffeis L, Pugni L, Pietrasanta C, et al. Iatrogenic anetoderma of prematurity: a case report and review of the literature. Case Rep Dermatol Med 2014; 2014:781493.
- Colditz PB, Dunster KR, Joy GJ, Robertson IM. Anetoderma of prematurity in association with electrocardiographic electrodes. J Am Acad Dermatol 1999; 41:479.
- Goujon E, Beer F, Gay S, et al. Anetoderma of prematurity: an iatrogenic consequence of neonatal intensive care. Arch Dermatol 2010; 146:565.
- Wain EM, Mellerio JE, Robson A, Atherton DJ. Congenital anetoderma in a preterm infant. Pediatr Dermatol 2008; 25:626.
- Zellman GL, Levy ML. Congenital anetoderma in twins. J Am Acad Dermatol 1997; 36:483.
- Patrizi A, Neri I, Virdi A, et al. Familial anetoderma: a report of two families. Eur J Dermatol 2011; 21:680.
- Karrer S, Szeimies RM, Stolz W, Landthaler M. Primary Anetoderma in children: report of two cases and literature review. Pediatr Dermatol 1996; 13:382.
- Connor CJ, Shchelochkov OA, Ciliberto H. Anetoderma in a patient with terminal osseous dysplasia with pigmentary defects. Am J Med Genet A 2015; 167A:2459.
- Velez MJ, Mesinkovska N, Bergfeld WF. Anetoderma arising in Reed syndrome: a case report and review of the literature. J Cutan Pathol 2015; 42:765.
- Oikarinen AI, Palatsi R, Adomian GE, et al. Anetoderma: biochemical and ultrastructural demonstration of an elastin defect in the skin of three patients. J Am Acad Dermatol 1984; 11:64.
- Zaki I, Scerri L, Nelson H. Primary anetoderma: phagocytosis of elastic fibres by macrophages. Clin Exp Dermatol 1994; 19:388.
- Hodak E, Shamai-Lubovitz O, David M, et al. Primary anetoderma associated with a wide spectrum of autoimmune abnormalities. J Am Acad Dermatol 1991; 25:415.
- Bergman R, Friedman-Birnbaum R, Hazaz B, et al. An immunofluorescence study of primary anetoderma. Clin Exp Dermatol 1990; 15:124.
- Kossard S, Kronman KR, Dicken CH, Schroeter AL. Inflammatory macular atrophy: immunofluorescent and ultrastructural findings. J Am Acad Dermatol 1979; 1:325.
- Venencie PY, Winkelmann RK. Monoclonal antibody studies in the skin lesions of patients with anetoderma. Arch Dermatol 1985; 121:747.
- Venencie PY, Bonnefoy A, Gogly B, et al. Increased expression of gelatinases A and B by skin explants from patients with anetoderma. Br J Dermatol 1997; 137:517.
- Ghomrasseni S, Dridi M, Gogly B, et al. Anetoderma: an altered balance between metalloproteinases and tissue inhibitors of metalloproteinases. Am J Dermatopathol 2002; 24:118.
- Hunt R, Chu J, Patel R, Sanchez M. Circumscribed lenticular anetoderma in an HIV-infected man with a history of syphilis and lichen planus. Dermatol Online J 2011; 17:2.
- Gambichler T, Reininghaus L, Skrygan M, et al. Fibulin Protein Expression in Mid-dermal Elastolysis and Anetoderma: A Study of 23 Cases. Acta Derm Venereol 2016; 96:708.
- Requena L, González-Guerra E, Angulo J, et al. Anetodermic mycosis fungoides: a new clinicopathological variant of mycosis fungoides. Br J Dermatol 2008; 158:157.
- Thornsberry LA, LoSicco KI, English JC 3rd. The skin and hypercoagulable states. J Am Acad Dermatol 2013; 69:450.
- Ruiz-Irastorza G, Cuadrado MJ, Ruiz-Arruza I, et al. Evidence-based recommendations for the prevention and long-term management of thrombosis in antiphospholipid antibody-positive patients: report of a task force at the 13th International Congress on antiphospholipid antibodies. Lupus 2011; 20:206.
- Lewis KG, Bercovitch L, Dill SW, Robinson-Bostom L. Acquired disorders of elastic tissue: Part II. decreased elastic tissue. J Am Acad Dermatol 2004; 51:165.
- Verma SB, Nandkumar G. Rediscovering Perifollicular Elastolysis: A Hitherto Undocumented Entity in India. Indian J Dermatol 2015; 60:603.
- Wilson BB, Dent CH, Cooper PH. Papular acne scars. A common cutaneous finding. Arch Dermatol 1990; 126:797.
- Cho S, Jung JY, Lee JH. Treatment of anetoderma occurring after resolution of Stevens-Johnson syndrome using an ablative 10,600-nm carbon dioxide fractional laser. Dermatol Surg 2012; 38:677.
- Lee SM, Kim YJ, Chang SE. Pinhole carbon dioxide laser treatment of secondary anetoderma associated with juvenile xanthogranuloma. Dermatol Surg 2012; 38:1741.
- Wang K, Ross NA, Saedi N. Anetoderma treated with combined 595-nm pulsed-dye laser and 1550-nm non-ablative fractionated laser. J Cosmet Laser Ther 2016; 18:38.
- Reiss F, Linn E. The therapeutic effect of epsilon-aminocaproic acid on anetoderma Jadassohn. Dermatologica 1973; 146:357.
- Braun RP, Borradori L, Chavaz P, et al. Treatment of primary anetoderma with colchicine. J Am Acad Dermatol 1998; 38:1002.
- CLINICAL MANIFESTATIONS
- Primary anetoderma
- - Associated disorders
- Secondary anetoderma
- Iatrogenic anetoderma of prematurity
- Other subtypes
- ADDITIONAL EVALUATION
- DIFFERENTIAL DIAGNOSIS
- PROGNOSIS AND FOLLOW-UP
- SUMMARY AND RECOMMENDATIONS