Refractile elastic fibers that are mixed with inflammatory and basophilic debris penetrate the epidermis. Such refractile elastic fibers may be seen in other conditions such as folliculitis, particularly perforating folliculitis. Penetration of the epidermis by elastic fibers can be seen in a variety of conditions such as keratoacanthomas. However, the balls or tangles of elastic fibers that are found in the papillary dermis in elastosis perforans serpiginosa are characteristic of the condition. The clinical presentation as annular or serpiginous lesions helps distinguish these lesions from folliculitis if the histology is not well-demonstrated.
 

	Scan power view. The epidermis is penetrated by a column of basophilic debris that starts in the dermis. Young scar tissue is seen to the left of the focus of penetration. A few foreign body type giant cells (not illustrated here) are in the scar tissue.
	Low power view of the upper right side of the scan power view picture.
	High power view of the base of the lesion depicted above. Note the refractile, eosinophilic elastic fibers mixed with the basophilic inflammatory debris.
	Low power view, elastic tissue stain. Epidermal penetration is seen, and there is a ball or tangle of elastic fibers in the papillary dermis near the right side of the picture.
	High power view of above. There is a ball or tangle of elastic fibers at the dermoepidermal junction.

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