Papular Elastosis

I report two typical cases of a cutaneous disorder caused by sunlight, which is common in Phoenix, Arizona, "The Valley of the Sun." It currently masquerades under the misnomer, adult colloid milium. It generally presents clinically as asymptomatic, shiny, smooth, firm papules, 1 to 10 mm in diameter, involving chronically sun-damaged skin of adults. The papules are generally multiple, but may be solitary, with various colorations. Microscopically, the papules all show severe elastosis involving most of the papillary cutis. It is most important to biopsy these lesions because clinically they may mimic a variety of skin lesions, some of which would require further investigations and therapy. This is a distinct clinical form of severe solar elastosis, which I propose to term papular elastosis.