LAUSR

Periumbilical perforating pseudoxanthoma elasticum is a rare acquired disorder, whose classification is still debatable. It may be a localised cutaneous variant type of pseudoxanthoma elasticum (although it may affect internal organs) or a separate disease entity. It classically presents with mildly pruritic keratotic papules on a periumbilical yellowish plaque. Stretching of abdominal wall connective tissue, for example, in obese and multiparous women is a purported cause of this disease. Histopathology reveals transepidermal elimination of altered calcific elastic fibres classically described as having ‘ravelled wool’ appearance. Few reports have been published detailing the dermoscopic features of this disease. This disease may appear placid; however, systemic comorbidities (especially vascular) are reported in a proportion of patients. We present two such cases with dermoscopic and histopathologic features.