Connective tissue fibers and cellular debris are extruded through the epidermis via a spiraling path. Cross section of a nidus of fibers and debris of elastosis perforans serpiginosa in transit through the epidermis, stained with hematoxylin and eosin. Elastic fibers are red. Connective tissue and debris of elastosis perforans serpiginosa emerging through the epidermis toward the surface, and elastic fibers in the nearby papillary dermis. The stain is a variation on acid orcein-Giemsa.
Elastic fibers are black.
Ultrastructure of penicillamine-induced skin lesions. Familial elastosis perforans serpiginosa. Elastosis perforans serpiginosa with systemic involvement. The perforating disorders. Penicillamine-induced elastosis perforans serpiginosa treated successfully with isotretinoin.