Main Article Content
Fibroelastolytic Papulosis, FEP, pseudoxanthoma elasticum-like papillary dermal elastolysis, PXE-PDE, White fibrous papulosis of the neck, WFPN, FEP treatment
Fibroelastolytic papulosis (FEP) is a rare, benign, acquired cutaneous disease with a histopathology that shows variable fibrosis and elastolysis of the papillary dermis. FEP clinically presents as white-ivory to yellow papules and plaques commonly occurring on the neck. Prior to this date there have been no specific treatment guidelines for FEP, thus various management options are explored in this case report.
We present a 62-year-old female with an isolated ivory, cobblestoned plaque with open comedones on the left shoulder since childhood. The histopathology confirmed the diagnosis of FEP. The patient had been previously treated with topical clindamycin, salicylic acid, tretinoin, and tazarotene without success.
This case demonstrates the importance of recognizing FEP, as clinical presentations can vary. FEP can be distressing to patients, and it is important to explore additional treatment options. Treatment options including topical retinoids and ablative lasers have been reported, but with limited and inconsistent success. However, due to the rarity of the disease there is currently no standard of care for the treatment of FEP and additional successful treatment options are needed.
2. Shimizu H, Kimura S, Harada T, Nishikawa T, White fibrous papulosis of the neck: a new clinicopathologic entity? J Am Acad Dermatol. 1989;20:1073-1077.
3. Rongioletti F, Rebora A. Pseudoxanthoma elasticum-like papillary dermal elastolysis. J Am Acad Dermatol. 1992;26: 648-50.
4. Balus L, Amantea A, Donati P, Fazio M, Guiliano MC, Bellocci M. Fibroelastolytic papulosis of the neck: a report of 20 cases. Br J Dermatol 1997; 137:461-466
5. Patterson A, Beasley K, Kobayashi T. Fibroelastolytic papulosis: histopathologic confirmation of disease spectrum variants in a single case. J CutanPathol. February 2016;43(2):142-147.
6. Jagdeo J, Ng C, Ronchetti IP, Wilkel C, Betcovitch L, Robinson-Bostom L. Fibroleastolytic papulosis. J Am Acad Dermatol. 2004;51:958-964
7. Song YC, Oh BH, Ko JH, Kim JY, Hwang YJ, Lee YW, et al. A case of Fibroelastolytic papulosis on the neck of a young man. Ann Dermatol. 2011;23:193-197
8. Maione V, Errichetti E, Stinco G, Orsaria M, and Patrone P. Fibroelastolytic papulosis of the neck treated with topical tretinoin. J Dermatol. Aug 2014;(8):758-759
9. Wang AR, Lewis K, Lewis M, Robinson-bosom L. Papillary dermal elastosis: a unique elastic tissue disorder or an unusual manifestation of pseudoxanthoma elasticum-like papillary dermal elastolysis? J CutanPathol. 2009;36:1010-1013
10. Lueangarum S. Panchaprateep, R. White fibrous papulosis of the neck treated with fractionated 1550-nm erbium glass laser: a case report. J Lasers in Med Sci. 2016;7940: 256-258
11. Ho, D., &Jagdeo, J. Fractionated Carbon Dioxide Laser Treatment of Fibroelastolytic Papulosis with Excellent Cosmetic results and Resolution of Pruritus. JDrugs Dermatol. Nov 2015; 14(11):1354-1357