Endoscopy Upper or lower endoscopy is indicated if the patient has hematemesis, occult blood in the stools, melena or frank bleeding. Endoscopy allows for treatment as well as diagnosis and is more sensitive than upper gastrointestinal series and barium enema. This procedure is useful in patients experiencing intermittent claudication or in patients with significantly diminished peripheral pulses to ensure adequate tissue perfusion. The fibers are fragmented, swollen and clumped in the middle and deep reticular dermis. Collagen fibers are also split and are said to unwind or flower.
Similar calcification is noted in the tunic media and intima of blood vessels.
Special stains for calcium and elastic fibers can confirm the diagnosis. Many of the pathological changes associated with PXE are irreversible, but there are prophylactic measures which can be undertaken to minimize the disease course. The sagging folds of skin present late in the course of PXE can be easily corrected by surgical excision of redundant skin folds if the patient desires. Cardiovascular lesions Diet and exercise are the main methods to minimize the extent of cardiovascular disease. Elevated serum lipids and hypertension aggravate the disease course.