Lionel Bercovitch, MD, Warren Alpert Medical School, Brown University, Providence, Rhode Island, provides details regarding pseudoxanthoma elasticum (PXE) and the skin. Dr Bercovitch discusses how to diagnose PXE, the primary lesions, and a study demonstrating a correlation between the number of affected areas and severe cardiovascular events or ophthalmologic complications. The role of plastic surgery in patients with PXE was also discussed.