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Abstract
EPS was diagnosed with further confirmation of histopathological examination [Figure 1]c. Further Verhoeff-van Gieson staining confirmed collagen fibers positive, elastic fibers positive [Figure 1]d,[Figure 1]e,[Figure 1]f.{Figure 1} EPS was a perforating disease that could be idiopathic, reactive, or drug induced. [3] As D-penicillamine performed as a copper chelater, which indirectly inhibited the activity of lysyl oxidase, abnormal elastic fibers were formed and accumulated. [...]D-penicillamine might also lead to posttranslational inhibition of collagen synthesis that would result in defective cross-linking. Foreign body granulomatous composed by histiocytes and polykaryocyte could be observed. [...]elastic fiber staining showed increasing number of coarser elastic fibers in the dermis. The treatment of EPS primarily consists of oral isotretinoin, intralesional injections of triamcinolone acetonide, topical application of tazarotene or allium cepa-allantoin-pentaglycan gel or cryotherapy. Determination of apoceruloplasmin by radioimmunoassay in nutritional copper deficiency, Menkes' kinky hair syndrome, Wilson's disease, and umbilical cord blood.