Pseudoxanthoma Elasticum (PXE)

Medically Reviewed on 5/22/2023

What is pseudoxanthoma elasticum (PXE)?

The connective tissues are the structural portions of the body that essentially hold the body cells together. These tissues form a framework or matrix for the body, and are composed of two major structural molecules, collagen and elastin. There are many different collagen protein types which vary in abundance depending on body area. Elastin is another protein which has the capability of stretching and returning to original length like a spring.

Pseudoxanthoma elasticum (PXE) is a rare disorder of degeneration of the elastic fibers with tiny areas of calcification in the skin, back of the eyes (retinae), and blood vessels. Interestingly, while elastin is the major component of ligaments (tissues which attach bone to bone), the ligaments are not apparently affected by pseudoxanthoma elasticum.

What causes pseudoxanthoma elasticum?

Pseudoxanthoma elasticum is inherited from the parents, either as an autosomal recessive or as an autosomal dominant trait. Identification of the gene responsible for PXE can facilitate the determination of the exact patterns of inheritance. Pseudoxanthoma elasticum is an inherited disorder of elastin.

What are the symptoms of pseudoxanthoma elasticum?

Pseudoxanthoma elasticum typically causes yellow-white small raised areas in the skin folds, often appearing in the second or third decades of life. These skin abnormalities frequently appear on the neck, armpits, and other areas that bend a great deal (referred to as flexure areas). The face is not affected by pseudoxanthoma elasticum. 

Other areas that can be affected in pseudoxanthoma elasticum include the heart which can be affected by atherosclerosis and mitral valve prolapse. Small blood vessels are abnormally fragile in patients with pseudoxanthoma elasticum because the blood vessel walls contain elastin and are weakened. This can lead to abnormal bleeding in such areas as the bowel and, very rarely, the uterus. Impairment of circulation to the legs can lead to pains in the legs while walking (claudication).

The doctor can often see abnormalities in the back of the eye (retinae) called angioid streaks, which are tiny breaks in the elastin-filled tissue there. These eye abnormalities can lead to blindness.

What is the treatment for pseudoxanthoma elasticum?

Treatment of patients with pseudoxanthoma elasticum involves monitoring organ function and consequences of the effects of the weakened elastin fibers in the body as well as measures to prevent injury and promote overall health.

For further information about Pseudoxanthoma Elasticum, please visit the following site: PXE International: Pseudoxanthoma Elasticum.

What is the prognosis for pseudoxanthoma elasticum?

There is no cure for pseudoxanthoma elasticum.

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Medically Reviewed on 5/22/2023
Medically reviewed by Norman Levine, MD; American Board of Dermatology

Wright, Teresa S., MD, FAAD, FAAP. "The Genodermatoses." UptoDate. Updated Feb. 22, 2016.