- Can plastic surgery repair skin folds (lax or redundant skin) from PXE?
- Can laser treatments help reduce skin folds from PXE?
- Is there any treatment for leaking or blistering from calcium deposits?
- What is the significance of prominent chin creases in individuals with PXE?
- Could the skin on my eyelids be affected by PXE?
Yes, the wrinkles, folds and looseness of the skin that may result from PXE (skin laxity and skin redundancy) can be removed from the neck, armpits, thighs, breasts and abdomen by means of plastic surgery. However, while plastic surgery is effective in reducing the excess skin, it has not been helpful in changing the ‘cobblestone´ appearance of the skin. It also cannot restore elasticity to the skin. There is no evidence that individuals with PXE heal more slowly or have any greater risk of complications than the general population. A possible complication in individuals with PXE is the slight possibility of calcium extrusion, in which a small bit of calcified matter may emerge through an incision. For more information, read the bulletin Plastic Surgery Considered. [March 2006]
There are two broad categories of laser treatment to smooth out the skin. One is the use of the laser to resurface the skin, in which superficial layers of skin are removed and the skin regenerates from hair follicles and sweat glands. The other is non-ablative resurfacing technique which tightens skin by changing the collagen in the dermis. None have been effective in correcting skin laxity in PXE, although there is no published experience on these techniques in PXE. However, the effects in PXE are in the deeper and middle regions of the dermis, making resurfacing impractical. [March 2006]
The phenomenon of leaking or blistering from calcium deposits is known as "perforating" PXE. The body extrudes some calcified degenerated elastic fibers through the surface of the skin. Redness, crusting, and inflammation can accompany the perforation. It is not true blistering as you might see with a burn. It is a transient phenomenon and will stop on its own. Although PXE International is not aware of any treatment for it, it is harmless. Your dermatologist should check the sites to make sure there isn't something else going on, such as folliculitis or superficial infection. [March 2006]
Prominent mental, or chin, creases can be described as vertical and oblique skin folds, and horizontal skin folds, located on the chin. A recent study1 showed that mental creases were present in 43 of 47 patients with PXE, affected the majority of individuals in every age group, and were significantly more common than in control patients. In fact, under the age of 30 years, two thirds of patients with PXE had mental creases whereas mental creases were not present in any age-matched control patients. Mental creases commonly occur in patients with PXE. In young patients they are a sensitive and highly specific physical finding of this disorder. The presence of exaggerated mental creases is, thus, a useful physical marker for PXE. Photos [March 2006]
1Lebwohl, M, Lebwohl, E, Bercovitch, L. Prominent mental (chin) crease: A new sign of pseudoxanthoma elasticum. J Am Acad Dermatol. 2003 April; 48(4): 620-22.
Looseness of eyelid skin (dermatochalasis) is not a feature of PXE that PXE International has observed or has been described in scientific literature. Fortunately it is easily corrected surgically through a procedure called blepharoplasty. [February 2008]
These are replies to general and specific questions which have been submitted to us in the past. Our responses may not apply to any particular individual´s situation and are not a substitute for medical advice given by a physician who is familiar with the individual´s case and who has examined the patient. In addition, the responses are updated on a periodic basis but may not be current.