Sixteen cases of acquired mid-dermal elastolysis have been reported in the literature. In 1977, Shelley identified this type of elastolysis as a separate entity and described three variants: post-inflammatory elastolysis with cutis laxa predominates in facial areas in African children. The initial inflammatory lesions are replaced by rough wrinkling of the skin; post-inflammatory elastolysis without cutis laxa; non-inflammatory elastolysis without cutis laxa as mid-dermal elastolysis. It is difficult nevertheless to classify certain cases reported in the literature. This would suggest that there is in reality a continuum of acquired elastolysis which could be classed according to a scale of decreasing initial inflammation. The non-inflammatory pole would represent mid-dermal elastolysis. The common features of the different types of elastolysis are dominated by the absence of a causative agent in most cases, unknown pathogenesis and the fact that the empirical treatments which have been used have been ineffective.