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Elastosis perforans serpiginosa (EPS) is an uncommon rind disease in which irregular springy tissue fibers, new connective tissue elements, and cellular rubble are expelled from the papillary dermis through the epidermis. Elastosis perforans serpiginosa is caused by several distinct things. It may be caused by a genetic abnormality or a side effect of medication. Elastic fibers are perceived by the skin to be abnormal and become the primary objects of an inflammatory attack. They may be abnormal as a result of genetic influence or penicillamine. Elastosis perforans serpiginosa is also called Lutz mieschers syndrome. Perforating diseases that may occur in conjunction with EPS include reactive perforating collagenosis, perforating folliculitis, and kyrle disease. The exect cause of abnormal elastic tissue is unknown but may be from a genetic mutation or external factors such as penicillamine. Elastosis perforans serpiginosa presents as a cluster of small reddish bumps 2-5 mm in diameter, often grouped in linear, circular or serpiginous patterns. Each lesion may have a central pit, which is sometimes filled by a crusty or scaly plug. When a person has elastosis perforans serpiginosa, the outer layer of the skin perceives abnormal elastic tissue to be a foreign object. When the elastic tissue is perceived as abnormal object, inflammation occurs. Primary lesions are eruptive, dome-shaped, eventually umbilicated papules, measuring a few to several millimeters in diameter. Usually, lesions are grouped in linear, arciform, circular, or serpiginous patterns, measuring several centimeters in diameter. Elastosis perforans serpiginosa usually appear on the back of the neck and less frequently on one or both arms, face, legs and trunk. It is more common in males than females.EPS normally appears during the second decade of living, but it may be seen in earlier childhood or recently in living. Elastosis perforans serpiginosa most commonly appears during early adulthood but may been seen in early childhood or late in life. The treatment options will depend on the cause and severity of the condition. Destructive methods appear to do more harm than good, often resulting in scarring worse than that expected from spontaneous healing. Freezing with liquid nitrogen may have helped several patients. Treatment with flashlight pulsed dye laser has appeared to be beneficial in case of Elastosis perforans serpiginosa in a patient with down syndrome.
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