Elastosis perforans serpiginosa (EPS) is a disorder of elastic fibers characterized by transepidermal elimination of abnormal elastic fibers. It is 1 of 4 classic perforating dermatoses that are now grouped under the umbrella term "acquired perforating dermatosis"; this grouping also includes reactive perforating collagenosis, perforating folliculitis, and Kyrle disease.

EPS may arise in childhood or early adulthood. There is a slight predilection for males. EPS is associated with Ehlers-Danlos syndrome type IV, Marfan syndrome, acrogeria, scleroderma, Rothman-Thompson syndrome (poikiloderma congenitale), cutis laxa, berry aneurysms, osteogenesis imperfecta, pseudoxanthoma elasticum, or Down syndrome in approximately 40% of cases. Up to 25%-50% of cases of EPS are related to D-penicillamine use in some series. Generally, EPS arises after extended periods of use of D-penicillamine. EPS may occur without an underlying disease or drug cause.