By Gary M. White, MD
Cutis laxa (CL) is a disorder in which the skin is lacking its normal elasticity. CL implies a more diffuse involvement of the skin whereas anetoderma implies localized loss of elasticity.
- CL may be congenital or acquired. When inherited AD, onset may be at any age with no systemic defect and a normal life. Alternatively, it may be inherited AR with a characteristic facies, pulmonary emphysema, cor pulmonale, and decreased lifespan.
- CL may be acquired and associated with systemic disease (e.g., amyloidosis, myeloma, paraproteins, fibrillar protein deposits) or it may be acquired following inflammatory skin diseases (e.g., allergic reaction to PCN, urticaria, SLE, or EM).
- CL may occur after many years of taking penicillamine. Workup should include a family history and an evaluation of lung function.
- Marshall's syndrome is an acquired form of cutis laxa without systemic involvement in which multiple erythematous papules and plaques appear first and upon resolution, leave wrinkled skin in their place.
- The De Barsy syndrome (DBS) is an extremely rare autosomal recessive disorder characterized by cutis laxa, a progeroid look, and corneal clouding.
Diffuse wrinkling of the skin is seen. The skin lacks its usually elasticity. The acquired type beginning in adulthood often begins insidiously with progressive development of lax skin beginning on the face and spreading downward. An urticarial or papulovesicular eruption may precede or accompany the changes. The patient may take on a premature aged appearance.
A lengthy workup may be necessary to exclude genetic, drug, inflammatory skin disease or other causes.
Plastic surgery may be done if indicated.
A woman, before at age 22, and after at age 26. Dermatology Online Journal 21;7
Loose sagging folds over the face in a 44-year-old woman. Indian J Dermatol Venereol Leprol 2014;80:454-6
Three-year-old with congenital cutis laxa from a gene defect in the elastin gene. Pediatr Dermatol. 2014 May-Jun;31(3):347-9
30-year-old woman with acquired cutis laxa of the abdomen--before and after surgery. Dermatol Res Pract. 2010; 2010: 402093
A 55-year-old woman with a ten-year history of loosening of her skin. Dermatology Online Journal 17(7)
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