Elastolysis mediodermalis is a rare disorder typically observed in middle-aged women. Sites of predilection are the trunk and upper arms. The clinical picture varies and may appear as cigarette paper-like wrinkling, perifollicular protrusions or reticular erythema. In contrast to the different clinical morphology, there is a consistent histology, i. e. localized, band-shaped, and rarely focal loss of elastic fibers in the middle dermis. The etiology of elastolysis mediodermalis is unclear. UV radiation or immunological mechanisms may increase the release of matrix metalloproteinases, leading to a degradation of elastic fibers. There is no effective treatment for this condition.