AUTHOR AND EDITOR INFORMATION

Section 1 of 9  

• Authors and Editors
• Introduction
• Clinical
• Differentials
• Workup
• Treatment
• Medication
• Follow-up
• References

INTRODUCTION

Section 2 of 9  

• Authors and Editors
• Introduction
• Clinical
• Differentials
• Workup
• Treatment
• Medication
• Follow-up
• References

Background

Pseudoatrophoderma colli is an unusual persistent dermatosis characterized by the presence of pigmented macules and plaques with a wrinkled atrophic appearance, involving the neck and the upper part of the trunk.

Becker and Muir reported the first case of pseudoatrophoderma colli in 1934. Since then, only single cases of this condition have been described; however, pseudoatrophoderma colli is likely more common than has been reported.

Pathophysiology

The nature of the disease remains uncertain. Some authors suggest that vitamin A deficiency may be a contributing factor to the cause of this condition. In the past, pseudoatrophoderma colli was considered a subvariety or a transitional form of confluent and reticulate papillomatosis of Gougerot and Carteaud, or a variant of parapsoriasis. Reports of familial cases of pseudoatrophoderma colli support the theory that it is an autosomal dominant dermatosis and a single disease entity.

Frequency

United States

Pseudoatrophoderma colli is rare.

International

It is rare, with only 10-20 cases reported.

Mortality/Morbidity

Pseudoatrophoderma colli is a benign disease with no associated mortality or morbidity.

Race

No clear racial predilection is described.

Sex

All patients described in the literature, except one, are females.

Age

The reported cases of pseudoatrophoderma colli are in patients aged 14-45 years.

CLINICAL

Section 3 of 9  

• Authors and Editors
• Introduction
• Clinical
• Differentials
• Workup
• Treatment
• Medication
• Follow-up
• References

History

• The atrophic-appearing macules and plaques usually appear insidiously and asymptomatically on the back of the neck.
• The appearance of the initial lesions, which tend to be hypopigmented and depressed, may resemble vitiligo.
• The eruption slowly encircles the neck and gradually spreads to the scapular and chest region, involving the intermammary area. In some instances, pseudoatrophic plaques continue to spread over the trunk and occasionally appear in other regions, such as the buttocks, the arms, and the lower part of the abdomen.
• The disease tends to spread gradually with partial regression and intervals, persisting for years or decades.
• Spontaneous regression has been described in 1 patient.
• Usually asymptomatic, it occasionally causes mild pruritus.

Physical

• Individual atrophic-appearing plaques and macules are 3-7 mm in diameter, oval or irregular, white or pink, and some coalesce in arcuate patches.
• The surface of the plaques may be shiny or wrinkled and may show some scaling.
• The lesions may form a dappled pattern of hypopigmented and hyperpigmented areas.
• The eruption is ill defined, and the pseudoatrophic plaques tend to be arranged in a vertical direction.
• The pseudoatrophic plaques are most often situated on the neck and the upper part of the thorax.

Causes

The cause of the condition is unknown.

• Vitamin A deficiency has been believed to be a possible factor contributing to the cause of pseudoatrophoderma colli.
• Some authors previously regarded it as a form of parapsoriasis or an epidermal nevus.
• Pseudoatrophoderma colli was also considered a variant of papillomatosis of Gougerot and Carteaud.

DIFFERENTIALS

Section 4 of 9  

• Authors and Editors
• Introduction
• Clinical
• Differentials
• Workup
• Treatment
• Medication
• Follow-up
• References

Other Problems to be Considered

Atrophic dermatofibromas

WORKUP

Section 5 of 9  

• Authors and Editors
• Introduction
• Clinical
• Differentials
• Workup
• Treatment
• Medication
• Follow-up
• References

Lab Studies

• Laboratory test results are within the reference range.

Histologic Findings

Histologic examination may be helpful to exclude the possibility of atrophic lichen planus, lichen sclerosus, poikiloderma, or porokeratosis of Mibelli.

The histologic findings in pseudoatrophoderma colli include hyperkeratosis of the epidermis with occasional parakeratosis and thinning of the granular layer, acanthosis of some areas with vacuolation and pyknosis of prickle cells, dilatation of superficial blood vessels, and minimal perivascular lymphocytic infiltration in the dermis. Fragmentation of the elastic tissue has also been described in some patients. Mild atrophy of the epidermis was noted only in single cases.

TREATMENT

Section 6 of 9  

• Authors and Editors
• Introduction
• Clinical
• Differentials
• Workup
• Treatment
• Medication
• Follow-up
• References

Medical Care

• In the past, therapy for pseudoatrophoderma colli included the use of a quartz lamp, keratolytics, topical corticosteroids, superficial radiation, and oral vitamin A.
• Spontaneous clearing was reported in 1 patient. Kauh et al treated a patient with 5% lactic acid in hydrophilic ointment, with relief of itching and scaliness and a decrease in pigmentation.

MEDICATION

Section 7 of 9  

• Authors and Editors
• Introduction
• Clinical
• Differentials
• Workup
• Treatment
• Medication
• Follow-up
• References

The goals of pharmacotherapy are to reduce morbidity and to prevent complications.

Drug Category: Keratolytics

These agents are used for symptomatic relief of dry scaling skin and for exfoliation.

FOLLOW-UP

Section 8 of 9  

• Authors and Editors
• Introduction
• Clinical
• Differentials
• Workup
• Treatment
• Medication
• Follow-up
• References

Prognosis

• The disease tends to spread gradually with partial regression and intervals, persisting for years or decades.
• Spontaneous clearing was reported in 1 patient.

REFERENCES

Section 9 of 9

• Authors and Editors
• Introduction
• Clinical
• Differentials
• Workup
• Treatment
• Medication
• Follow-up
• References

• Ayres S Jr, Ayres S 3rd. Pseudoatrophoderma colli. Arch Dermatol. 1955;71:763-4.
• Becker SW, Muir KB. Pseudo-atrophoderma colli: A hitherto undescribed condition. Arch Dermatol Syphilol. 1934;29:53-6.
• Frost K, Epstein E. Pseudoatrophoderma colli in sisters. Arch Dermatol Syphilol. 1939;40:755-61.
• Kanan MW, Kandil E. Pseudoatrophoderma colli in a male. Br J Dermatol. Jan 1969;81(1):65-8. [Medline].
• Kauh YC, Knepp ME, Luscombe HA. Pseudoatrophoderma colli. A familial case. Arch Dermatol. Oct 1980;116(10):1181-2. [Medline].
• Kesten BM, James HD. Pseudoatrophoderma colli, acanthosis nigricans, and confluent and reticular papillomatosis. AMA Arch Derm. Apr 1957;75(4):525-42. [Medline].
• Obermayer ME, Becker SW. Pseudoatrophoderma colli. Arch Dermatol. 1955;72:281-2.
• Palomeque FE, Hairston MA. Confluent and reticulated papillomatosis of Gougerot and Carteaud. Arch Dermatol. Jul 1965;92(1):49-51. [Medline].

Article Last Updated: Dec 4, 2006