A case of Marshall's syndrome (postinflammatory elastolysis)

Abstract

Sir,

Cutis laxa is a rare connective tissue disorder, which may be inherited or acquired. The disease is characterized by sagging and wrinkling of the skin and may also affect other organ systems. Marshall's syndrome is a type of acquired cutis laxa characterized by cutaneous involvement alone and occurs following inflammatory dermatoses such as Sweet's syndrome.

A 28-years-old man presented with tiny reddish elevated lesions on various parts of his body since six months [Figure 1]. The patient also noticed sagging of his facial skin, coinciding with the onset of these papules. Dermatological examination revealed multiple erythematous papules on his trunk, along with sagging and wrinkling of the facial skin [Figure 2]. This was more pronounced on the helices of his ears [Figure 3] and the skin elasticity was decreased, resulting in an aged appearance. Skin biopsy from the asymptomatic erythematous papules on the trunk revealed a normal epidermis with dermal interstitial neutrophilic infiltrates. Special stains for elastin revealed fragmentation of elastic fibers. [Figure 4]. Laboratory investigations were within the normal range.