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Abstract:  Focal absence of elastic fibers is a defining characteristic of three rare, clinically similar conditions: nevus anelasticus, papular elastorrhexis, and eruptive collagenoma. We present a 16-year-old with nevus anelasticus treated with intralesional steroid injections, resulting in erythematous atrophic depressions. We also review the English language literature on nevus anelasticus, papular elastorrhexis, and eruptive collagenoma. There may be sufficient clinical and histopathologic similarity to indicate that these three entities represent a single disease or disease spectrum. We believe that this entity should be referred to as papular elastorrhexis.