[Skip to Navigation]
Access to paid content on this site is currently suspended due to excessive activity being detected from your IP address Please contact the publisher to request reinstatement.
December 1997

Pruritic Hyperkeratotic Facial Papules

Author Affiliations

Indiana University Medical School, Indianapolis

Arch Dermatol. 1997;133(12):1579-1580. doi:10.1001/archderm.1997.03890480099015

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?

DIAGNOSIS:  Trichostasis spinulosa.

DISCUSSION  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