India rubber skin

Alternative names
Hyperelastic skin

Definition
Hyperelastic skin can be readily stretched beyond the limits of normal skin and will return to its normal state.

Considerations
Hyperelastic skin is most often seen in the Ehlers-Danlos syndrome. People with this disorder are sometimes referred to as rubber men (or women) because of the increased elasticity of their skin and hyperextensible joints (the joints can be bent more than is normally possible).

Hyperelasticity occurs as a result of the production of abnormal collagen fibers. Collagen is a fibrous, insoluble protein that makes up much of the body’s connective tissue.

Common Causes

     
  • Ehlers-Danlos syndrome

Other diseases that may cause easily stretchable skin include Marfan syndrome, pseudoxanthoma elasticum, osteogenesis imperfecta, cutis laxa, cutaneous T-cell lymphoma, and sun-related changes of older skin.

Home Care
People with hyperelastic skin are more likely than others to experience damage to the skin (cuts, scrapes, scarring). The skin may be more delicate than normal skin. Extra care must be taken to avoid damage to the skin, and the skin should be examined frequently for problems. Consult your health care provider for specific recommendations.

Call your health care provider if

     
  • your child appears to have delicate skin  
  • the skin appears to be very stretchy

What to expect at your health care provider’s office
Your doctor will perform a physical examination.

Your doctor may ask questions about your symptoms, such as:

     
  • time pattern       o Did the skin appear abnormal at or near the time of birth, or did this develop over time?  
  • quality       o Is there a history of the skin becoming damaged easily, or being slow to heal?  
  • detailed family history (Ehlers-Danlos syndrome is an inheritable disorder)       o Was Ehlers-Danlos syndrome suspected or confirmed as a diagnosis for you or any member of your family?  
  • other       o What other symptoms are also present?

The physical examination may include detailed skin, skeleton, and muscle examination. The joints may be moved in several directions to assess the distance and direction of movement in each joint.

If Ehlers-Danlos syndrome is suspected, medical tests may include:

     
  • lysyl oxidase (an enzyme detected with a blood test)  
  • lysyl hydroxylase (an enzyme detected with a blood test)  
  • serum copper level  
  • serum ceruloplasmin level  
  • collagen typing (determines the particular type of collagen fiber affected; this can help to predict future problems)  
  • platelet aggregation test  
  • skin biopsy

If Ehlers-Danlos syndrome is diagnosed, your physician may wish to refer you to other health care providers such as rheumatologists, ophthalmologists, geneticists, and dentists.

Johns Hopkins patient information

Last revised: December 3, 2012
by Martin A. Harms, M.D.

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All ArmMed Media material is provided for information only and is neither advice nor a substitute for proper medical care. Consult a qualified healthcare professional who understands your particular history for individual concerns.