Pseudoxanthoma elasticum and angioid streaks

A 37-year-old woman presented with asymptomatic, yellowish, skin lesions over neck since past 8 years. The lesions were slowly progressive. No other member in the family was having similar complaints. She had no systemic complaints like intermittent claudication, chest pain and gastrointestinal bleeding. Blood pressure was within normal limits. Cutaneous examination revealed multiple, discrete, yellowish papules over the front and lateral aspects of neck. Loose folds of skin were also noticed over both axillae. Skin biopsy findings from one of the representative lesions over neck were suggestive of pseudoxanthoma elasticum (PXE). Ocular examination on fundoscopy revealed multiple, irregular radial lines emanating from the optic disc involving both the eyes (Figure