Perforating pseudoxanthoma elasticum. Its distinction from elastosis perforans serpiginosa

It is not generally appreciated that pseudoxanthoma elasticum (PXE) can be associated with epidermal perforation by elastic fibers. We report an example of this phenomenon. The term "perforating PXE" is suggested and a distinction is made from elastosis perforans serpiginosa (EPS). We believe that most reported cases of coexistence of PXE and EPS are perforating PXE and that the coexistence of EPS has not been clearly demonstrated.