Cutis laxa

Cutis laxa (also known as "Chalazoderma," "Dermatochalasia," "Dermatolysis," "Dermatomegaly," "Generalized elastolysis," "Generalized elastorrhexis," and "Pachydermatocele" ) is a group of rare connective tissue disorders in which the skin becomes inelastic and hangs loosely in folds.

Causes
In most cases, cutis laxa is inherited. Autosomal dominant, autosomal recessive and X-linked recessive forms have been described, but acquired forms also occur.

In patients suffering from cutis laxa, mutations in the elastic fibers comprising the dermis have been identified.

Cutis laxa may be caused by mutations in the genes: ELN, ATP6V0A2, ATP7A, FBLN4, FBLN5, and PYCR1. A related neurocutaneous syndrome may be caused by mutations in the gene ALDH18A1 aka P5CS.

Presentation
It is characterized by skin that is loose, hanging, wrinkled, and lacking in elasticity. The loose skin is often most noticeable on the face, resulting in a prematurely aged appearance. The affected areas of skin may be thickened and dark. In addition, the joints are loose (hypermobility) because of lax ligaments and tendons. When cutis laxa is severe, it can also affect the internal organs. The lungs, heart, intestines, or arteries may be affected with a variety of severe impairments. In some cases, hernias and outpouching of the bladder can be observed.