COMMUNICATIONS AND BRIEF REPORTS Localized Cutis Laxa and Blepharoplasty ZAFER OZSOY , MD, Ã A YDIN GOZU, MD, Ã DENIZ DAYICIOGLU, MD, Ã OZGUR METE, MD, y AND NESIMI BUYUKBABANI, MD y The authors have indicated no significant interest with commercial supporters. C utis laxa is a rare disease characterized by abundant skin laxity and a resultant premature aged appearance with mild to severe systemic man- ifestations. 1,2 Upper eyelid skin redundancy and laxity can represent a localized form of cutis laxa. Aesthetic surgery can be performed safely and can give excellent results in such cases provided that systemic examination is performed. Cutis laxa’s inheritance pattern can be autosomal dominant, autosomal recessive, or X-linked reces- sive. 1,2 Acquired forms have been described and mostly occur due to drug ingestion, paraneoplastic conditions, or postinflammatory conditions. 1–3 The clinical features are variable in both congenital and acquired forms and range from localized to severe and potentially life-threatening systemic disease with genitourinary, gastrointestinal, cardiovascular, skel- etal, and respiratory involvement. 1–3 Histopatho- logic findings are characterized by a reduction in the number of elastic fibers and associated degenerative changes. 2,3 Similar changes can occur in the elastic tissues elsewhere in the body. 2,3 There are a small number of reports describing acquired localized cutis laxa involving the face, fingers, and toes. 2,4,5 The age of the patient and the rarity of the localized form of cutis laxa solely in upper eyelids are highlighted. Case Report A 20-year-old female patient was admitted to our hospital due to complaints of bilateral upper eyelid sagging (Figure 1). The skin laxity and redundancy were first recognized 10 years previously and progressed gradually. The skin was light pink and hung loosely. It seemed to be thinner and more fragile. Apart from the eyelid pathology, no partic- ular abnormality was noted on the complete physical evaluation, and laboratory tests including complete blood count, total protein, b2-microglobulin, IgG, IgM, C3, C1q, C4, and antinuclear antibody (ANA). High-resolution computerized tomography of the thorax and echocardiography were within normal ranges. Skin biopsies were taken and histopathologic examination revealed that dermal elastic fibers were markedly decreased. This feature is highlighted by orcein stain (Figure 2). The pathologic findings were compatible with cutis laxa. The clinical findings suggested to the localized form of the disease. Therefore, bilateral upper blepharoplasty was per- formed without fat tissue excision. Postoperative results were satisfactory (Figures 3 and 4). & 2007 by the American Society for Dermatologic Surgery, Inc.  Published by Blackwell Publishing  ISSN: 1076-0512  Dermatol Surg 2007;33:1510–1512  DOI: 10.1111/j.1524-4725.2007.33326.x 1510 Figure 1. Preoperative appearance of the patient showing redundancy and laxity of the upper eyelid skin. Ã Department of Plastic and Reconstructive Surgery, Vakif Gureba Training Hospital, Istanbul; y Department of Pa- thology, Istanbul University, Istanbul Medical Faculty, Istanbul, Turkey