First described by Shelley and Wood in 1977, <sup>1Shelley WB, Wood MG Wrinkles due to idiopathic loss of mid-dermal elastic tissue Br J Dermatol 1977 ;  97 : 441-445 [cross-ref]

Cliccare qui per andare alla sezione Riferimenti</sup> mid-dermal elastolysis (MDE) is a rare acquired disorder in which there is a bandlike absence of elastic tissue limited to the mid-dermis. In their patient, MDE developed in an area previously involved with recurrent episodes of urticaria. We describe a 15-year-old white girl with well-circumscribed, minimally palpable yellow-white plaques and wrinkling diagnosed histologically as MDE in areas clincally diagnosed 5 years previously as granuloma annulare. As in the first described patient, five years elapsed between clearance of the original skin lesions and the clinical appearance of MDE. To our knowldege, we report the first adolescent case of MDE localized to previous sites of lesions clinically consistent with granuloma annulare and propose that MDE represents an abnormal end-stage reaction to multiple processes. (J Am Acad Dermatol 1997;37:870-2.)