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Pseudoxanthoma elasticum (PXE, OMIM#264800) is an autosomal recessive metabolic disorder characterized by progressive ectopic mineralization of soft connective tissue [1]. To date, diagnosis of PXE is confirmed with skin biopsy and/or genotyping. Histopathology findings include fragmented, clumped and mineralized elastic fibers, and calcium deposits in the mid-dermis, mainly consisting of calcium hydroxyapatite and calcium hydrogen phosphate [2]. According to ultrastructural studies, two types of calcification were described: fine precipitates inside the elastic fibers in their center and bulky deposits which by surrounding the fibers, lead to deformation and breakage [3]. Coiled, split collagen fibers with irregular diameter and flower-like collagen fibrils are also observed sometimes [4].

Low concentration eosin staining for high chemical contrast nonlinear microscope mosaic imaging of skin alterations in Pseudoxanthoma elasticum