Perifollicular Elastolysis: A Systematic Review of Clinical Characteristics, Histopathology, and Therapeutic Outcomes

Perifollicular elastolysis (PE) is an underrecognized disorder characterized by asymptomatic, noninflammatory follicular papules, primarily on the face and acne-prone areas. A systematic review of 16 studies, mostly case reports and series, revealed consistent histopathological findings of selective perifollicular loss or fragmentation of elastic fibers. However, therapeutic evidence is limited and varied. The largest study on treatment involved fractional CO2 laser therapy, showing short-term improvement but with transient post-inflammatory hyperpigmentation in 15.6% of patients. The review highlights the need for standardized terminology, diagnostic criteria, and prospective studies to establish effective treatments for PE.