REPORT OF A CASE
A 34-year-old woman presented with a 10-year history of pruritic black papules on her face. Her medical history was unremarkable.Her physical examination showed numerous open comedolike lesions distributed over the glabella, nose, cheeks, and chin (Figure 1). Some of these lesions were excoriated and on closer examination were noted to be dilated follicles containing tufts of hairs. The findings of the remainder of her physical examination were unremarkable.Keratinaceous debris and vellus hairs from several follicles were removed by a hair pull and examined under the microscope. (Figure 2).What is your diagnosis?
Trichostasis spinulosa is an underrecognized yet common condition. It is characterized clinically by follicular keratotic plugs in which multiple vellus hairs are embedded. The lesions usually present as pruritic, hyperkeratotic papules. The disease can affect all age groups and both sexes; it commonly develops develops in elderly persons who have suffered long-term sun damage. Patients
Noel N, Gerstein D, Faust H. Pruritic Hyperkeratotic Facial Papules. Arch Dermatol. 1997;133(12):1579–1580. doi:10.1001/archderm.1997.03890480099015
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