Evaluation of patients with suspected anetoderma

We reserve the term "secondary anetoderma" for anetoderma that develops at sites of pre-existing skin disease. However, some authors consider patients with systemic conditions or laboratory abnormalities that may be associated with anetoderma to have secondary anetoderma.

* The diagnosis of anetoderma usually can be made with physical examination alone.

¶ The skin biopsy should include the mid-dermis. A 4 mm punch biopsy is adequate. Loss or significant reduction of elastic fibers in the dermis is the primary histopathologic finding.

Δ The differential diagnosis includes other elastic tissue disorders characterized by cutaneous atrophy. Refer to UpToDate content on anetoderma for details.

◊ Secondary anetoderma can result from a variety of cutaneous autoimmune, infectious, inflammatory, tumoral, and deposition disorders.

§ Patients with a history suggestive of familial anetoderma should be evaluated for signs of ocular, neurologic, gastrointestinal, cardiovascular, or bony abnormalities.

¥ We typically perform serologic testing for antiphospholipid antibodies. We also perform a review of systems and physical examination, with a focus on features suggestive of thrombotic disorders, antiphospholipid syndrome, or autoimmune disease.

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Evaluation of patients with suspected anetoderma