As a consequence of aging, fine skin wrinkles appear secondary to the decreased synthesis and net loss of dermal collagen and elastin.

Ehlers-Danlos Syndrome

defective collagen synthesis due to deficiency in procollagen peptidase, the enzyme that cleaves terminal propeptides from procollagen in the extracellular space.

Type I is the most common ( among ~6 types)

• Droopy ears,
• hyperextensible skin, fragile, easy bruisability, poor wound healing
• joint hyperlaxity; tendency toward hip, shoulder, knee, and clavicular dislocation
• MVP, tricuspid valve prolapse, aortic root dilatation; dissecting aneurysm, ASD
• Pt. can develop acute MR secondary to myxomatous degeneration and rupture of the chordae tendineae
• blue sclera, myopia, glaucoma, ectopia lentis, retinal detachment
• intracranial aneurysm