We present a clinical case of a rare acquired disease of elastic skin tissue, mid-dermal elastolysis, in a 65-year-old male with multiple comorbidity. According to the past medical history, for 23 years, the patient has had recurrent red spots and rash of unknown cause on the torso and extremities. Four years ago, the patient noticed a thinning of the skin on his left arm. Examination of the skin on the torso and extremities revealed solitary erythematous spots of pink and purple color with areas of slight skin wrinkling in some of them. On the internal surface of the left forearm a well-defined focus of fine wrinkles with small pink spots was revealed. Histological examination of wrinkled skin with hematoxylin and eosin staining showed a morphological pattern without nosological specificity. Orcein staining revealed a stripe-like zone of lack of elastic fibers in the middle part of the reticular dermis, whereas, in the papillary dermis, superficial and deep parts of the reticular dermis, and around the appendicular structures, elastic fibers were preserved. The results of clinical examination and morphological investigations were consistent with mid-dermal elastolysis. The etiology of the disease has not yet been established; the pathogenesis has not been sufficiently studied. Immune inflammation, activation of elastic fiber destruction due to increased elastase synthesis, an imbalance between the production of matrix metalloproteinases and their tissue inhibitors, and impaired elastic tissue component turnover play an important role in the pathogenesis of mid-dermal elastolysis. No effective treatment for the disease has been developed. As this condition is rare, the presented clinical case can help practitioners make a correct diagnosis promptly and choose a proper approach to patient management.