Anetoderma presents as discrete, sac-like outpouchings of skin (the "buttonhole" sign), whereas mid-dermal elastolysis causes diffuse areas of fine, "cigarette-paper" wrinkling without herniation.
This is a more severe, generalized condition of loose, sagging, inelastic skin that hangs in folds, a much more dramatic presentation than the subtle wrinkling of mid-dermal elastolysis.
PXE is an inherited disease distinguished by its characteristic yellowish, "plucked-chicken skin" papules in flexural areas and associated systemic findings (angioid streaks in the eye).
