# Anetoderma

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Medical condition

Anetoderma Other names Anetoderma maculosa,[1] Anetoderma maculosa cutis,[1] Atrophia maculosa cutis,[1] and Macular atrophy.[2] Specialty Dermatology

**Anetoderma** is a benign but uncommon disorder that causes localized areas of flaccid or herniated sac-like skin due to a focal reduction of dermal [elastic tissue](/source/Elastic_fiber).[3] Anetoderma is subclassified as primary anetoderma, secondary anetoderma, [iatrogenic](/source/Iatrogenesis) anetoderma of prematurity, congenital anetoderma, familial anetoderma, and drug-induced anetoderma.[4]

Two forms of primary anetoderma have been identified, based on whether an inflammatory response took place prior to the atrophy's appearance, anetoderma of Jadassohn-Pellizzari, in which inflammation occurs before the atrophic lesions appear, and anetoderma of Schweninger-Buzzi, in which inflammation is not present.[5]

## Signs and symptoms

Typically pink [macules](/source/Macules) that are round or oval and have a diameter of 0.5 to 1 centimeters grow on the trunk, thighs, and upper arms. They are less frequently found on the neck, face, and other areas. Usually, the soles, palms, and scalp are unaffected. Every macule grows for one or two weeks until it reaches a size of 2-3 centimeters.[6] Larger [erythematous](/source/Erythema) plaques can occasionally be seen, and nodules have also been identified as the main lesion.[3]

Lesions range widely in number from fewer than five to one hundred or more.[6] The lesions do not change throughout a person's life, and new lesions frequently take years to appear.[3] When the lesions combine, they create sizable atrophic regions that are identical to acquired [cutis laxa](/source/Cutis_laxa). They could unite to encircle sizable regions, particularly along the neck and at the base of the limbs.[6]

## Causes

Primary anetoderma is an idiopathic development of [atrophic](/source/Atrophy) lesions in skin areas that appeared normal prior to the onset of [atrophy](/source/Atrophy).[7]

Secondary anetoderma is a skin disease that develops in areas where there has previously been or is currently skin pathology. It has been linked to a variety of conditions, such as [acne](/source/Acne),[8] [urticaria pigmentosa](/source/Urticaria_pigmentosa),[9] [syphilis](/source/Syphilis),[6] [leprosy](/source/Leprosy),[8] [granuloma annulare](/source/Granuloma_annulare),[10] [insect bites](/source/Insect_bites),[11] and [antiphospholipid syndrome](/source/Antiphospholipid_syndrome).[12] Secondary anetoderma has been linked to infectious, inflammatory,[13] and tumorous conditions.[6]

Macular depressions or skin outpouchings linked to the loss of dermal elastic tissue that are observed in premature infants are referred to as anetoderma of prematurity. According to reports, the location of monitoring electrodes or leads, such as [ECG](/source/Electrocardiography) electrodes, may be related to these cutaneous lesions.[14]

Case reports have described instances of [congenital](/source/Congenital) anetoderma presenting as anetoderma on the trunk of premature infants at birth.[15][16]

[Penicillamine](/source/Penicillamine) administration has been linked to drug-induced anetoderma, especially in [Wilson disease](/source/Wilson's_disease) patients.[5]

Familial anetoderma is rare and is inherited autosomally. The familial form usually appears in the first ten years of life and may show up only as skin manifestations, but it can also be linked to ocular, neurological, and bony abnormalities.[17]

## Diagnosis

Anetoderma can be diagnosed clinically. But if the diagnosis proves to be difficult, a [skin biopsy](/source/Skin_biopsy)—ideally a [punch biopsy](/source/Punch_biopsy)—can be carried out to include the mid dermis.[18] Under a [microscope](/source/Microscope), the [epidermis](/source/Epidermis) of anetoderma exhibits a nearly total loss of [elastic fibers](/source/Elastic_fiber) in the reticular and papillary dermal layers. A dermal periadnexal and perivascular infiltrate containing [histiocytes](/source/Histiocyte) and [plasma cells](/source/Plasma_cell) can also be seen in the [histopathology](/source/Histopathology) of the lesion.[19]

In lesional skin, elastophagocytosis and tiny fragmented elastic fibrils can be seen in addition to the histopathology on [electron microscopy](/source/Electron_microscope).[20][21] [Desmosine](/source/Desmosine) has been used to quantify the amount of [elastin](/source/Elastin) in lesional skin, which is considerably lower in anetoderma, since it is a major [amino acid](/source/Amino_acid) in elastin.[22]

### Classification

There are five subtypes of anetoderma: drug-induced anetoderma, familial anetoderma, prematurity-associated anetoderma, primary (idiopathic) anetoderma, and secondary anetoderma from a previous dermatosis. The Jadassohn-Pellizzari type and the Schweninger-Buzzi type are the historical subtypes of the primary type, which is found in areas of previously normal skin. While the Schweninger-Buzzi type of anetoderma develops in skin that appears normal with no predisposition skin changes, the Jadassohn-Pellizzari type occurs following the occurrence of inflammatory or urticarial lesions. These terms are now obsolete because the two primary types are identical histologically as well as having a similar disease course.[4]

## See also

- [List of cutaneous conditions](/source/List_of_cutaneous_conditions)

- [Atrophoderma](/source/Atrophoderma)

## References

1. ^ [***a***](#cite_ref-Bolognia_1-0) [***b***](#cite_ref-Bolognia_1-1) [***c***](#cite_ref-Bolognia_1-2) Rapini, Ronald P.; Bolognia, Jean L.; Jorizzo, Joseph L. (2007). *Dermatology: 2-Volume Set*. St. Louis: Mosby. [ISBN](/source/ISBN_(identifier)) [978-1-4160-2999-1](https://en.wikipedia.org/wiki/Special:BookSources/978-1-4160-2999-1).

1. **[^](#cite_ref-Fitz2_2-0)** Freedberg, et al. (2003). *Fitzpatrick's Dermatology in General Medicine*. (6th ed.). Page 1027. McGraw-Hill. [ISBN](/source/ISBN_(identifier)) [0-07-138076-0](https://en.wikipedia.org/wiki/Special:BookSources/0-07-138076-0).

1. ^ [***a***](#cite_ref-unusual_presentation_3-0) [***b***](#cite_ref-unusual_presentation_3-1) [***c***](#cite_ref-unusual_presentation_3-2) Aghaei, Shahin; Sodaifi, Manouchehr; Aslani, Fatemeh Sari; Mazharinia, Nazila (2004). ["An unusual presentation of anetoderma: a case report"](https://www.ncbi.nlm.nih.gov/pmc/articles/PMC515307). *BMC Dermatology*. **4** 9. BMC. [doi](/source/Doi_(identifier)):[10.1186/1471-5945-4-9](https://doi.org/10.1186%2F1471-5945-4-9). [PMC](/source/PMC_(identifier)) [515307](https://www.ncbi.nlm.nih.gov/pmc/articles/PMC515307). [PMID](/source/PMID_(identifier)) [15318943](https://pubmed.ncbi.nlm.nih.gov/15318943).

1. ^ [***a***](#cite_ref-review_of_the_literature_4-0) [***b***](#cite_ref-review_of_the_literature_4-1) Kineston, Donald P; Xia, Yang; Turiansky, George W (June 2008). "Anetoderma: a case report and review of the literature". *Cutis*. **81** (6): 501–506. [PMID](/source/PMID_(identifier)) [18666393](https://pubmed.ncbi.nlm.nih.gov/18666393).

1. ^ [***a***](#cite_ref-Collagen_Vascular_Disorders_5-0) [***b***](#cite_ref-Collagen_Vascular_Disorders_5-1) Paller, Amy S.; Mancini, Anthony J. (January 1, 2016). ["Collagen Vascular Disorders"](https://www.sciencedirect.com/science/article/abs/pii/B9780323244756000224). *Hurwitz Clinical Pediatric Dermatology*. Elsevier. p. 509–539.e8. [doi](/source/Doi_(identifier)):[10.1016/B978-0-323-24475-6.00022-4](https://doi.org/10.1016%2FB978-0-323-24475-6.00022-4). [ISBN](/source/ISBN_(identifier)) [9780323244756](https://en.wikipedia.org/wiki/Special:BookSources/9780323244756). Retrieved December 31, 2023.

1. ^ [***a***](#cite_ref-Clinical_findings_6-0) [***b***](#cite_ref-Clinical_findings_6-1) [***c***](#cite_ref-Clinical_findings_6-2) [***d***](#cite_ref-Clinical_findings_6-3) [***e***](#cite_ref-Clinical_findings_6-4) PY, Venencie; RK, Winkelmann; BA, Moore (1984). "Anetoderma. Clinical findings, associations, and long-term follow-up evaluations". *Archives of Dermatology*. **120** (8). Arch Dermatol: 1032–1039. [doi](/source/Doi_(identifier)):[10.1001/archderm.120.8.1032](https://doi.org/10.1001%2Farchderm.120.8.1032). [ISSN](/source/ISSN_(identifier)) [0003-987X](https://search.worldcat.org/issn/0003-987X). [PMID](/source/PMID_(identifier)) [6465909](https://pubmed.ncbi.nlm.nih.gov/6465909).

1. **[^](#cite_ref-Intravenous_Penicillin_7-0)** Emer, Jason; Roberts, Daniel; Sidhu, Harleen; Phelps, Robert; Goodheart, Herbert (2013). ["Generalized Anetoderma after Intravenous Penicillin Therapy for Secondary Syphilis in an HIV Patient"](https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3760601). *The Journal of Clinical and Aesthetic Dermatology*. **6** (8). Matrix Medical Communications: 23–28. [PMC](/source/PMC_(identifier)) [3760601](https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3760601). [PMID](/source/PMID_(identifier)) [24003347](https://pubmed.ncbi.nlm.nih.gov/24003347).

1. ^ [***a***](#cite_ref-Mastocytosis_evolving_8-0) [***b***](#cite_ref-Mastocytosis_evolving_8-1) Thivolet, J; Cambazard, F; Souteyrand, P; Pierini, A M (1981). "Mastocytosis evolving into anetoderma. Review of the literature". *Annales de dermatologie et de venereologie*. **108** (3): 259–266. [PMID](/source/PMID_(identifier)) [7020556](https://pubmed.ncbi.nlm.nih.gov/7020556).

1. **[^](#cite_ref-Tender_Periungual_Nodules_9-0)** Holland, Theresa T. (January 1, 1992). "Tender Periungual Nodules". *Archives of Dermatology*. **128** (1). American Medical Association (AMA): 105–6, 108–9. [doi](/source/Doi_(identifier)):[10.1001/archderm.1992.01680110117021](https://doi.org/10.1001%2Farchderm.1992.01680110117021). [ISSN](/source/ISSN_(identifier)) [0003-987X](https://search.worldcat.org/issn/0003-987X). [PMID](/source/PMID_(identifier)) [1739277](https://pubmed.ncbi.nlm.nih.gov/1739277).

1. **[^](#cite_ref-granuloma_annulare_10-0)** zkan, ebnem; Fetil, Emel; zler, Fatih; Pabucuolu, Uur; Yalin, Nagihan; Gne, Ali Tahsin (2000). "Anetoderma secondary to generalized granuloma annulare". *Journal of the American Academy of Dermatology*. **42** (2). Elsevier BV: 335–338. [doi](/source/Doi_(identifier)):[10.1016/s0190-9622(00)90106-3](https://doi.org/10.1016%2Fs0190-9622%2800%2990106-3). [ISSN](/source/ISSN_(identifier)) [0190-9622](https://search.worldcat.org/issn/0190-9622). [PMID](/source/PMID_(identifier)) [10640927](https://pubmed.ncbi.nlm.nih.gov/10640927).

1. **[^](#cite_ref-Pilomatricoma_11-0)** Shames, Bruce S.; Nassif, Aude; Bailey, Cynthia S.; Saltzstein, Sidney L. (1994). "Secondary Anetoderma Involving a Pilomatricoma". *The American Journal of Dermatopathology*. **16** (5). Ovid Technologies (Wolters Kluwer Health): 557–566. [doi](/source/Doi_(identifier)):[10.1097/00000372-199410000-00020](https://doi.org/10.1097%2F00000372-199410000-00020). [ISSN](/source/ISSN_(identifier)) [0193-1091](https://search.worldcat.org/issn/0193-1091). [PMID](/source/PMID_(identifier)) [7802171](https://pubmed.ncbi.nlm.nih.gov/7802171).

1. **[^](#cite_ref-antiphospholipid_syndrome_12-0)** Disdier, Patrick; Harlé, Jean-Robert; Andrac, Lucille; Verrot, Denis; Bolla, Gilles; Marco, Marielle San; Weiller, Pierre-Jean (1994). "Primary anetoderma associated with the antiphospholipid syndrome". *Journal of the American Academy of Dermatology*. **30** (1). Elsevier BV: 133–134. [doi](/source/Doi_(identifier)):[10.1016/s0190-9622(08)81902-0](https://doi.org/10.1016%2Fs0190-9622%2808%2981902-0). [ISSN](/source/ISSN_(identifier)) [0190-9622](https://search.worldcat.org/issn/0190-9622). [PMID](/source/PMID_(identifier)) [8277016](https://pubmed.ncbi.nlm.nih.gov/8277016).

1. **[^](#cite_ref-Sjögren's_syndrome_13-0)** Herrero-González, J-E; Herrero-Mateu, C (2002). "Primary anetoderma associated with primary Sjögren's syndrome". *Lupus*. **11** (2). SAGE Publications: 124–126. [doi](/source/Doi_(identifier)):[10.1191/0961203302lu139cr](https://doi.org/10.1191%2F0961203302lu139cr). [ISSN](/source/ISSN_(identifier)) [0961-2033](https://search.worldcat.org/issn/0961-2033). [PMID](/source/PMID_(identifier)) [11958576](https://pubmed.ncbi.nlm.nih.gov/11958576). [S2CID](/source/S2CID_(identifier)) [26022639](https://api.semanticscholar.org/CorpusID:26022639).

1. **[^](#cite_ref-Colditz_Dunster_Joy_Robertson_1999_pp._479–481_14-0)** Colditz, Paul B.; Dunster, Kimble R.; Joy, Gloria J.; Robertson, Ivan M. (1999). "Anetoderma of prematurity in association with electrocardiographic electrodes". *Journal of the American Academy of Dermatology*. **41** (3). Elsevier BV: 479–481. [doi](/source/Doi_(identifier)):[10.1016/s0190-9622(99)70126-x](https://doi.org/10.1016%2Fs0190-9622%2899%2970126-x). [ISSN](/source/ISSN_(identifier)) [0190-9622](https://search.worldcat.org/issn/0190-9622). [PMID](/source/PMID_(identifier)) [10459128](https://pubmed.ncbi.nlm.nih.gov/10459128).

1. **[^](#cite_ref-Mary_Wain_Mellerio_Robson_Atherton_2008_pp._626–629_15-0)** Mary Wain, E.; Mellerio, Jemima E.; Robson, Alistair; Atherton, David J. (2008). "Congenital Anetoderma in a Preterm Infant". *Pediatric Dermatology*. **25** (6). Wiley: 626–629. [doi](/source/Doi_(identifier)):[10.1111/j.1525-1470.2008.00785.x](https://doi.org/10.1111%2Fj.1525-1470.2008.00785.x). [ISSN](/source/ISSN_(identifier)) [0736-8046](https://search.worldcat.org/issn/0736-8046). [PMID](/source/PMID_(identifier)) [19067869](https://pubmed.ncbi.nlm.nih.gov/19067869). [S2CID](/source/S2CID_(identifier)) [39038946](https://api.semanticscholar.org/CorpusID:39038946).

1. **[^](#cite_ref-Zellman_Levy_1997_pp._483–485_16-0)** Zellman, Glenn L.; Levy, Moise L. (1997). "Congenital anetoderma in twins". *Journal of the American Academy of Dermatology*. **36** (3). Elsevier BV: 483–485. [doi](/source/Doi_(identifier)):[10.1016/s0190-9622(97)80236-8](https://doi.org/10.1016%2Fs0190-9622%2897%2980236-8). [ISSN](/source/ISSN_(identifier)) [0190-9622](https://search.worldcat.org/issn/0190-9622). [PMID](/source/PMID_(identifier)) [9091489](https://pubmed.ncbi.nlm.nih.gov/9091489).

1. **[^](#cite_ref-Familial_anetoderma_17-0)** Patrizi, Annalisa; Neri, Iria; Virdi, Annalucia; Misciali, Cosimo; D’acunto, Carmine (2011). "Familial anetoderma: a report of two families". *European Journal of Dermatology*. **21** (5). John Libbey Eurotext: 680–685. [doi](/source/Doi_(identifier)):[10.1684/ejd.2011.1450](https://doi.org/10.1684%2Fejd.2011.1450). [ISSN](/source/ISSN_(identifier)) [1167-1122](https://search.worldcat.org/issn/1167-1122). [PMID](/source/PMID_(identifier)) [21719400](https://pubmed.ncbi.nlm.nih.gov/21719400).

1. **[^](#cite_ref-Cook_Puckett_2023_g989_18-0)** Cook, Jordan C.; Puckett, Yana (July 3, 2023). ["Anetoderma"](https://www.ncbi.nlm.nih.gov/books/NBK560605/). StatPearls Publishing. [PMID](/source/PMID_(identifier)) [32809440](https://pubmed.ncbi.nlm.nih.gov/32809440). Retrieved December 31, 2023.

1. **[^](#cite_ref-Monoclonal_antibody_19-0)** Venencie, Pierre Y.; Winkelmann, R. K. (June 1985). ["Monoclonal antibody studies in the skin lesions of patients with anetoderma"](https://jamanetwork.com/journals/jamadermatology/article-abstract/546151). *Archives of Dermatology*. **121** (6). JAMA: 747–749. [doi](/source/Doi_(identifier)):[10.1001/archderm.1985.01660060061021](https://doi.org/10.1001%2Farchderm.1985.01660060061021). [PMID](/source/PMID_(identifier)) [3873911](https://pubmed.ncbi.nlm.nih.gov/3873911). Retrieved 31 December 2023.

1. **[^](#cite_ref-Histopathologic_findings_20-0)** Venencie, Pierre Y.; Winkelmann, R. K. (1984). ["Histopathologic findings in anetoderma"](https://jamanetwork.com/journals/jamadermatology/article-abstract/545298). *Archives of Dermatology*. **120** (8). JAMA: 1040–1044. [doi](/source/Doi_(identifier)):[10.1001/archderm.1984.01650440070022](https://doi.org/10.1001%2Farchderm.1984.01650440070022). [PMID](/source/PMID_(identifier)) [6465910](https://pubmed.ncbi.nlm.nih.gov/6465910). Retrieved 31 December 2023.

1. **[^](#cite_ref-ZAKI_SCERRI_NELSON_1994_pp._388–390_21-0)** ZAKI, I.; SCERRI, L.; NELSON, H. (1994). "Primary anetoderma: phagocytosis of elastic fibres by macrophages". *Clinical and Experimental Dermatology*. **19** (5). Oxford University Press (OUP): 388–390. [doi](/source/Doi_(identifier)):[10.1111/j.1365-2230.1994.tb02688.x](https://doi.org/10.1111%2Fj.1365-2230.1994.tb02688.x). [ISSN](/source/ISSN_(identifier)) [0307-6938](https://search.worldcat.org/issn/0307-6938). [PMID](/source/PMID_(identifier)) [7955494](https://pubmed.ncbi.nlm.nih.gov/7955494).

1. **[^](#cite_ref-Oikarinen_Palatsi_Adomian_Oikarinen_1984_pp._64–72_22-0)** Oikarinen, Aarne I.; Palatsi, Riitta; Adomian, Gerald E.; Oikarinen, Heljä; Clark, Joan G.; Uitto, Jouni (1984). "Anetoderma: Biochemical and ultrastructural demonstration of an elastin defect in the skin of three patients". *Journal of the American Academy of Dermatology*. **11** (1). Elsevier BV: 64–72. [doi](/source/Doi_(identifier)):[10.1016/s0190-9622(84)70136-8](https://doi.org/10.1016%2Fs0190-9622%2884%2970136-8). [ISSN](/source/ISSN_(identifier)) [0190-9622](https://search.worldcat.org/issn/0190-9622). [PMID](/source/PMID_(identifier)) [6736354](https://pubmed.ncbi.nlm.nih.gov/6736354).

## Further reading

- Olivo, M. P. (January 1, 1993). "Anetoderma. Anetoderma, the primary type". *Archives of Dermatology*. **129** (1). American Medical Association (AMA): 106–107. [doi](/source/Doi_(identifier)):[10.1001/archderm.129.1.106](https://doi.org/10.1001%2Farchderm.129.1.106). [ISSN](/source/ISSN_(identifier)) [0003-987X](https://search.worldcat.org/issn/0003-987X). [PMID](/source/PMID_(identifier)) [8420480](https://pubmed.ncbi.nlm.nih.gov/8420480).

- Ghomrasseni, Sabah; Dridi, Myriam; Gogly, Bruno; Bonnefoix, Mireille; Vabres, Pierre; Venencie, Pierre Yves; Pellat, Bernard; Godeau, Gaston (2002). "Anetoderma". *The American Journal of Dermatopathology*. **24** (2). Ovid Technologies (Wolters Kluwer Health): 118–129. [doi](/source/Doi_(identifier)):[10.1097/00000372-200204000-00003](https://doi.org/10.1097%2F00000372-200204000-00003). [ISSN](/source/ISSN_(identifier)) [0193-1091](https://search.worldcat.org/issn/0193-1091). [PMID](/source/PMID_(identifier)) [11979071](https://pubmed.ncbi.nlm.nih.gov/11979071). [S2CID](/source/S2CID_(identifier)) [40039865](https://api.semanticscholar.org/CorpusID:40039865).

## External links

- [UpToDate](https://www.uptodate.com/contents/anetoderma)

- [DermNet](https://dermnetnz.org/topics/anetoderma)

Classification D ICD-11: EE41.1 ICD-10: L90.1 L90.2 ICD-9-CM: 701.8 MeSH: D057088 DiseasesDB: 29805 SNOMED CT: 238828009 External resources eMedicine: article/1073850 Orphanet: 228272 Scholia: Q3616643

v t e Cutaneous keratosis, ulcer, atrophy, and necrobiosis Epidermal thickening keratoderma: Keratoderma climactericum Paraneoplastic keratoderma Acrokeratosis paraneoplastica of Bazex Aquagenic keratoderma Drug-induced keratoderma psoriasis Keratoderma blennorrhagicum keratosis: Seborrheic keratosis Clonal seborrheic keratosis Common seborrheic keratosis Irritated seborrheic keratosis Seborrheic keratosis with squamous atypia Reticulated seborrheic keratosis Dermatosis papulosa nigra Keratosis punctata of the palmar creases other hyperkeratosis: Acanthosis nigricans Confluent and reticulated papillomatosis Callus Ichthyosis acquisita Arsenical keratosis Chronic scar keratosis Hyperkeratosis lenticularis perstans Hydrocarbon keratosis Hyperkeratosis of the nipple and areola Inverted follicular keratosis Lichenoid keratosis Multiple minute digitate hyperkeratosis PUVA keratosis Reactional keratosis Stucco keratosis Thermal keratosis Viral keratosis Warty dyskeratoma Waxy keratosis of childhood other hypertrophy: Keloid Hypertrophic scar Cutis verticis gyrata Necrobiosis/granuloma Necrobiotic/palisading Granuloma annulare Perforating Generalized Subcutaneous Granuloma annulare in HIV disease Localized granuloma annulare Patch-type granuloma annulare Necrobiosis lipoidica Annular elastolytic giant-cell granuloma Granuloma multiforme Necrobiotic xanthogranuloma Palisaded neutrophilic and granulomatous dermatitis Rheumatoid nodulosis Interstitial granulomatous dermatitis/Interstitial granulomatous drug reaction Foreign body granuloma Beryllium granuloma Mercury granuloma Silica granuloma Silicone granuloma Zirconium granuloma Tattoo Carbon stain Other/ungrouped eosinophilic dermatosis Granuloma faciale Dermis/ localized CTD Cutaneous lupus erythematosus chronic: Discoid Panniculitis subacute: Neonatal ungrouped: Chilblain Lupus erythematosus–lichen planus overlap syndrome Tumid Verrucous Rowell's syndrome Scleroderma/ Morphea Localized scleroderma Localized morphea Morphea–lichen sclerosus et atrophicus overlap Generalized morphea Atrophoderma of Pasini and Pierini Pansclerotic morphea Morphea profunda Linear scleroderma Atrophic/ atrophoderma Lichen sclerosus Anetoderma Schweninger–Buzzi anetoderma Jadassohn–Pellizzari anetoderma Atrophoderma of Pasini and Pierini Acrodermatitis chronica atrophicans Semicircular lipoatrophy Follicular atrophoderma Linear atrophoderma of Moulin Atrophia maculosa varioliformis cutis Perforating Kyrle disease Reactive perforating collagenosis Elastosis perforans serpiginosa Perforating folliculitis Acquired perforating dermatosis Skin ulcer Pyoderma gangrenosum Other Calcinosis cutis Sclerodactyly Poikiloderma vasculare atrophicans Ainhum/Pseudo-ainhum

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