Papular elastorrhexis

Papular elastorrhexis is a rare, benign connective tissue disorder of the skin characterized by the appearance of small, firm, non-follicular, white to skin-colored papules distributed primarily on the trunk, particularly the back, chest, and upper extremities. The condition results from a loss or fragmentation of elastic fibers in the dermis, a finding confirmed on histological examination. The papules are typically asymptomatic (not painful or itchy) and are usually 1–5 mm in diameter. Papular elastorrhexis predominantly affects the integumentary system (skin) and does not involve internal organs. The condition most commonly presents in adolescence or young adulthood and tends to remain stable over time. It has been debated whether papular elastorrhexis represents a distinct entity or falls within the spectrum of connective tissue nevi, particularly the collagenous type. Some authors consider it closely related to or overlapping with disseminated eruptive collagenomas. The exact cause remains unclear, and most reported cases appear to be sporadic, with no clear familial inheritance pattern identified in the majority of cases. There is no established curative treatment for papular elastorrhexis. Management is primarily cosmetic and reassurance-based, as the condition is benign and does not progress to systemic disease. Some case reports have described partial improvement with treatments such as topical retinoids or laser therapy, but evidence for efficacy is limited and largely anecdotal. Patients are generally advised that the condition poses no health risk, though the cosmetic appearance may be a concern for some individuals.

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