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December 2009

Multiple Comedonelike Lesions Encircling the Anal Orifice—Diagnosis

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Copyright 2009 American Medical Association. All Rights Reserved. Applicable FARS/DFARS Restrictions Apply to Government Use.2009

Arch Dermatol. 2009;145(12):1447-1452. doi:10.1001/archdermatol.2009.289-b

Biopsy findings showed the presence of multiple large, open comedones. Each lesion was filled with lamellar keratinous debris as well as several hair shaft fragments and was characterized by slightly atrophic infundibular epithelium. Serial sections showed focal continuity with folliculosebaceous structures. The dermis surrounding the lesions was unremarkable and devoid of inflammatory infiltrates.

According to the literature, perianal comedones are exceedingly rare and only 2 cases have been reported to date.1,2 These cases were both associated with local chronic corticosteroid use, which would suggest a mechanism analogous to that of steroid acne, possibly combined with the occlusive nature of the ointment base.

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