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Trichostasis spinulosa (TS) is a follicular disorder characterized by the retention of multiple vellus hairs in a hyperkeratotic dilated hair follicle. TS is considered as a common disorder; however, it is often underdiagnosed due to its asymptomatic nature. Although the condition frequently affects the face or extremities, the widespread distribution of TS over the entire body has been once reported in a patient with chronic renal failure. To emphasize the infrequent presentation of TS, we herein report a 57-year-old male with an unusual location of TS.

Introduction: Many dermatological conditions require extraction of material from the lesion followed by visualization under a microscope. However, visualization of the extracted material can be done using a dermoscope instead. We propose “extraction dermoscopy” as an addition to the already existing treasury that dermoscopy holds. Methods: After approval from the institutional ethics committee, a cross-sectional study was carried out in a tertiary care hospital. Polarized and non-polarized versions of in vivo dermoscopy, as well as extraction dermoscopy, were performed on a total of 77 lesions, including 5 eruptive vellus hair cysts, 2 cilia incarnata externum, 10 trichostasis spinulosa, 20 keratosis pilaris, 20 molluscum contagiosum, and 20 lesions of milia. Heine Delta 20T and Dino-Lite Premier AM4113T were employed for dermoscopic examination. Results: A total of 77 lesions were selected, including 5 eruptive vellus hair cysts, 2 cilia incarnata externum, 10 trichostasis spinulosa, 20 keratosis pilaris, 20 molluscum contagiosum, and 20 lesions of milia. Extraction dermoscopy of the eruptive vellus cysts revealed skin color to brownish colored cysts with a bunch of pigmented hair. Similarly, findings of all other lesions were described and recorded post-extraction. Conclusion: Extraction dermoscopy helps confirm the diagnosis without visualization under a microscope. Its application in recent times makes the explanation of the nature of many disorders to patients easier, and demonstration of extracted lesions may further improve doctor-patient communication.

Context: Trichostasis spinulosa (TS) is a common but underdiagnosed follicular disorder involving retention of successive telogen hair in the hair follicle. Laser hair removal is a newer treatment modality for TS with promising results. Aims: This study aims to evaluate the efficacy of 800 nm diode laser to treat TS in Asian patients. Subjects and Methods: We treated 50 Indian subjects (Fitzpatrick skin phototype IV–V) with untreated trichostasis spinulosa on the nose with 800 nm diode laser at fluence ranging from 22 to 30 J/cm2 and pulse width of 30 ms. The patients were given two sittings at 8 week intervals. The evaluation was done by blinded assessment of photographs by independent dermatologists. Results: Totally 45 (90%) patients had complete clearance of the lesions at the end of treatment. Five (10%) subjects needed one-third sitting for complete clearance. 45 patients had complete resolution and no recurrence even at 2 years follow-up visit. 5 patients had partial recurrence after 8–9 months and needed an extra laser session. Conclusions: Laser hair reduction in patients with TS targets and removes the hair follicles which are responsible for the plugged appearance. Due to permanent ablation of the hair bulb and bulge, the recurrence which is often seen with other modalities of treatment for TS is not observed here.

This chapter presents with granulosis rubra nasi, Fox-Fordyce disease, ophiasis and sisaipho hair regrowth pattern, pseudopelade of Brocq, alopecia areata sparing white hairs within lesion, coexistence of acquired hypertrichosis and scalp alopecia, woolly hair, monilethrix, pili annulati, trichonodosis, hair cast, trichostasis spinulosa, cutaneous pili migrans, red hair, permanent poliosis after plucking, congenital leukonychia totalis, hyperpigmentation of the nail from lead deposition, longitudinal erythronychia, chromonychias, subungual splinter hemorrhage, sebaceous gland hyperplasia, as well as sebaceous hyperplasia within epidermis after scald.

Dermoscopic examination of hair and scalp, also named "trichoscopy," is an essential tool in diagnosis of hair and scalp diseases. Trichoscopy is fast and noninvasive and can be used to evaluate hair disorders in all body areas. Body hair disorders are uncommon, and most publications on their dermoscopic features are limited to case reports or series. In this review we present the available information on the dermoscopic diagnosis of body hair disorders including keratosis pilaris, trichostasis spinulosa, pili multigemini, circle hairs, rolled hairs, eruptive vellus hair cyst, and ingrown hairs.

Background: Data about the contribution and the implications of dermoscopy in trichostasis spinulosa (TS) are lacking in the literature. Objective: To describe dermoscopic features of TS in a large sample of patients and to correlate dermoscopy with clinical characteristics of the patients and therapeutic responses to medical treatments. Methods: A descriptive study was conducted (from October 2015 to June 2016) at the Department of Dermatology of Fez in Morocco. Dermoscopic signs were divided into signs of hair retention (SHR) and follicular keratosis (FK). Results: SHR was severe in 8.8% and minimal in 40.5% of all cases. Vellus hairs were observed in 81.6% of all cases and hair tufts were described in 48.7%. Dermoscopic blackhead-like structures (DBH) were found in 53.9% of all cases. FK was observed as orange-yellowish keratotic plugs in 92.7% of all cases. Therapeutic demand was significantly related to female gender (p = 0.002) and recurrences after medical treatment (p = 0.004). Complete improvement after medical treatment was only described in patients with DBH and minimal SHR (p = 0.001). Conclusion: Dermoscopy not only increases the accuracy of the clinical diagnosis in TS, but a new description of dermoscopic classification has also been proposed leading to therapeutic implications.

Trichostasis spinulosa is a rarely diagnosed disorder of the pilosebaceous unit, characterized by retention of telogen hairs within the dilated follicles. A hair tuft can be seen protruding from the follicles. We present a case of trichostasis spinulosa associated with intradermal melanocytic nevi, where dermoscopy helps to identify this entity.

Trichostasis spinulosa (TS) is a common yet underdignosed condition affecting hair follicles. Diagnosis is based on the clinical features, hair mount, and dermoscopy. Here, the authors describe a case of TS in a nevoid distribution wherein dermoscopy aided the diagnosis.How to cite this articleAnkad BS, Shah S, Mallapur AA. Nevoid Trichostasis Spinulosa: Dermoscopic Point of View. Int J Dermoscop 2017;1(2):65-66.

Trichostasis spinulosa (TS) is a follicular disorder in which multiple hairs in a keratinous sheath project above the skin surface. Current treatments provide temporary relief and side effects are common. We report the successful treatment of TS in 20 patients using a short-pulsed 755-nm alexandrite laser. The 20 patients (skin types II-V) presented with TS lesions on the tip of their nose. All patients received a single treatment (one to three passes) with the laser with cold air cooling but without anaesthesia or analgesia. Treatment parameters were as follows: pulse duration 0.5 ms, fluence 15-17 J/cm(2), and spot size 5 mm. The entire procedure required less than 5 min to perform. The patients were followed up for 3 months for any adverse effects or recurrence. In all patients the lesions disappeared immediately after treatment with minimal or no pain. Erythema was minimal and lasted 5-20 min in all patients. Patients were very satisfied. The treated areas were still clear 4 to 5 weeks later, and a second treatment was not considered necessary. There were adverse effects other than the erythema and there was no recurrence within the follow-up period of 3 months. A single treatment with a short-pulsed 755-nm alexandrite laser appears to be a rapid, minimally painful, and effective treatment for TS in patients of skin types II to V.

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Alopecia areata is a common autoimmune disorder that leads to nonscarring hair loss. Black dots, also called comedo-like cadaver hairs, can be found in almost 50% of alopecia areata patients and indicate disease activity. Trichostasis spinulosa is a follicular disorder resulting from the retention of numerous hairs surrounded by a keratinous sheath in dilated follicles. Trichostasis spinulosa is a relatively common but underdiagnosed disorder of hair follicles. Here, we describe a man with alopecia areata of the eyebrows, androgenetic alopecia and trichostasis spinulosa at the vertex and show how dermoscopy can be useful in distinguishing black dots from Trichostasis spinulosa lesions.

Background Trichostasis spinulosa (TS) is a common disorder of hair follicle, characterized by spinous plugs. Topical treatments offer temporary relief but permanent removal of the abnormal follicles using hair removal lasers may result in a definite cure. Objective To evaluate the safety and efficacy of 755-nm alexandrite laser for the treatment of TS lesions. Patients and methods Two consecutive 755-nm alexandrite laser treatments were performed one month apart. The clinical response and adverse effects were assessed four weeks after the first and second treatments and 20 weeks after the second treatment. Results Thirty one patients with skin phototypes II to IV completed the study. At the last follow up visit, a decrease in dark-plug density of greater than 50% was noted in 16 patients (51.3%), while only three patients (9.7%) had an improvement of greater than 75%. Ten of the 21 patients (47.6%) with skin type III and six of the seven patients (85.7%) with skin type IV achieved at least 50% improvement in lesions at the last follow up visit (P = 0.1). Conclusion The 755-nm alexandrite laser can safely and effectively reduce TS lesions lasting for a relatively long time in patients with skin types III–IV.

Background Trichostasis spinulosa (TS) is a common, underdiagnosed cosmetic skin condition. Objectives The main objectives of this study were to determine the occurrence of TS relative to age and gender, to analyze its cutaneous distribution, and to investigate any possible familial basis for this condition, its impact on patients, and the types and efficacy of previous treatments. Methods All patients presenting to the outpatient dermatology clinic at the study institution and their relatives were examined for the presence of TS and were questioned about family history and previous treatment. Photographs and biopsies of suspected cases of TS were obtained. Results Of 2400 patients seen between August and December 2013, 286 patients were diagnosed with TS (135 males, 151 females; prevalence: 11.9%). Women presented more frequently than men with complaints of TS (6.3 vs. 4.2%), and more women had received prior treatment for TS (10.5 vs. 2.8%). The most commonly affected sites were the face (100%), interscapular area (10.5%), and arms (3.1%). Lesions involved the nasal alae in 96.2%, the nasal tip in 90.9%, the chin in 55.9%, and the cheeks in 52.4% of patients. Only 15.7% of patients had forehead lesions, and only 4.5% had perioral lesions. Among the 38 previously treated patients, 65.8% reported temporary improvement. Conclusions Trichostasis spinulosa is a common condition that predominantly affects the face in patients of all ages. Additional studies employing larger cohorts from multiple centers will be required to determine the prevalence of TS in the general population.

BACKGROUND Trichostasis spinulosa (TS) is a common follicular disorder that results from the retention of multiple vellus hairs within pilosebaceous follicles. A variety of treatment modalities have been used with variable but largely transient success. OBJECTIVES To determine whether a pulsed diode laser irradiation would provide a therapeutic response to TS for a prolonged period. METHODS Thirteen subjects with untreated TS and skin phototypes III, IV, and V were treated with a 800-nm pulsed diode laser at fluences ranging from 24 to 40 J/cm2 (mean, 36 J/cm2) and a 12- to 20-ms (mean 18 ms) pulse width. Two treatments were delivered at 4-week intervals. Evaluation of improvement was performed at 4 and 20 weeks after the last treatment by a blinded assessment of clinical photographs. RESULTS Complete clearing of the lesions was achieved for a period of 8 to 12 weeks. A decrease in dark-plug appearance of greater than 50% was noted in half of the subjects 20 weeks after the second treatment. No pigmentary changes and scarring occurred in any subjects. CONCLUSION Pulsed diode laser proved to be a safe and long-term effective treatment for TS in dark-skinned individuals.

Trichostasis spinulosa is a common inapparent follicular disorder of retained bundles of vellus hairs. There exist two variants: the classical variant presenting with a non-itching, comedo-like lesion on the face in the elderly, and the pruritic variant presenting with itching, follicular papules located on the limbs in young adults. Here we present the microscopic study of the pruritic variant of trichostasis spinulosa in two patients and provide a review of the literature.

Common variations seen in a nevus include neurotization and halo phenomenon. Other less common presentations are desmoplastic nevus, balloon cell nevus, halo nevus, dermal nevus with fatty infiltration, nevus with ossification, Meyerson’s (inflamed) nevus, recurrent nevus, nevus with trichostasis spinulosa, nevus with pseudovascular change, nevus with myxoid change, and combined nevus.

Trichostasis spinulosa (TS) is very common yet unrecognized disorder of the hair follicle. Usually occurring on the mid-face, especially on the nose, TS occurs more commonly in young, adult dark skinned women. Here, we present a case of TS at an unusual site diagnosed on the basis of history, hair mount, dermoscopy, and histopathology.

Trichostasis spinulosa (TS) is a relatively common but underdiagnosed disorder of the pilosebaceous follicles in which there is follicular hyperkeratosis of a dilated hair follicle with retention of telogen hairs. Clinical presentation of this disorder can be confused with comedogenic acne, keratosis pilaris, eruptive vellus hair cysts, and Favre–Racouchot syndrome. A case of a nonpruritic variant of TS in a 16-year-old boy is reported because of its unusual location as well as presentation in the lower eyelid, giving an appearance of a double eyelid. Although TS is common, it is mostly under diagnosed and henceforth underreported hair follicular disorder. The differential diagnosis of this disorder should be always kept in mind even if it presents in unusual location to avoid unnecessary application of various therapeutic modalities.

Trichostasis spinulosa is an uncommon midfacial disease with negative impact on self esteem and appearance. Many available treatments provide only short time improvement. We report a 36-year-old female treated with a series of four capryloyl salicylic acid peelings with significant improvement for at least 24 months.

Trichostasis spinulosa (TS) is a follicular disorder that is characterized by spinous plugs on the nose, cheeks, chin and interscapular areas [1, 2]. Histologically, multiple pigmented vellus hairs are enveloped in a keratinous sheath within a dilated hair follicle and sometimes there is a mild perifollicular inflammation [1]. Abnormalities of the follicular unit, microorganisms, in particular Propionibacterium acne and Pityrosporum, endocrine and metabolic disorders and external factors are the [...]

A 50-year-old female visited our department for the treatment of rosacea. Dermatological examination revealed erythematous papules and plaques over both cheeks. Black macules were found on the nose [Figure 1], but the patient was not worried about the lesions. Dermoscopic (×25 and ×60) examination revealed that the black macules were vellus hairs [Figure 2]. The hairs were plucked and observed under dermascope which showed multiple vellus hairs bundled in a funnel-like structure [Figure 3]. The above findings were suggestive of trichostasis spinulosa (TS). Patient refused treatment for the lesions. Figure 1 Multiple black macules on nose Figure 2 Dermoscopic (×25 and ×60) examination revealing vellus hairs Figure 3 Plucked hairs observed under dermascope (×25 and ×60) showing multiple vellus hairs bundled in a funnel-like structure TS is a very common but unrecognized disorder of pilosebaceous unit. It is a midfacial disease that occurs in younger age in female patients with Fitzpatrick skin type III or higher. It may also occur in light-skinned older people with excessive ultraviolet-exposure.[1,2] TS was first recognized by the German dermatologist Felix Franke in 1901, who named it “Pinselhaar” (paintbrush hair). In 1913, Noble first coined the term “trichostasis spinulosa.”[1] The exact etiology of this disease is not known. Abnormal angulation of the hair follicle may lead to the entrapment of vellus hairs. Follicular hyperkeratosis of a dilated vellus hair follicle leading to retention of successive telogen hairs is another explanation. Number of retained hairs may range from 5 to 60.[1,2] TS occurs sporadically, but many trigger factors have been identified. These include topical minoxidal, topical steroids, chronic renal failure, dust, oils, ultraviolet light, heat, and irritants.[1,2] Two variants of TS have been described: Nonpruritic type, which is classical and often seen in the elderly as asymptomatic blackhead-like lesions located on the face. The other variant is the pruritic type, characterized by multiple pinhead-sized papules on the trunk and upper extremities in young adults.[3] The present case is a classical type with the involvement of nose. Various modalities of treatment are tried with variable results which includes emollients, hydroactive adhesive tapes, local keratolytics, local and oral retinoids.[1] Repeated peeling with capryloyl salicylic acid has given good result.[2] Herein we present a classical case of TS to increase the awareness of this common disease.

A 75-year-old man presented with a peculiar facial appearance, having a diffuse yellowish hue, atrophic skin, and deep wrinkles and furrows involving the entire face, most prominently the forehead, zygomatic, and malar areas [Figure 1]. Multiple large comedones and numerous 2-6 mm sized yellow-to-brown colored papules and nodules were present, clustered in the periocular region and over the dorsum of a patulous nose. The lesions had been present for at least 15 years with gradual coarsening of facial features. Lateral madarosis of both eyebrows was evident, but leprosy was clinically ruled out based on absence of history suggestive of any sensory or motor impairment and lack of cutaneous lesions suggestive of leprosy, Hypoesthesia, thickening of peripheral nerves, any motor deficit or deformity on examination. He also had depigmentation of lower lips but was not bothered by it and did not seek any treatment for the same. The patient was a farmer by occupation with history of significant daily sun exposure and had never followed any specific sun-protection measures or used sunscreens. He had been a chronic heavy smoker with 50 smoking pack years (25 cigarettes per day for 40 years). The patient was totally unconcerned about the facial disfigurement and wanted to consult regarding itching in his groin region, which on examination revealed tinea cruris. Histopathology from the cheek revealed grossly solar damaged epidermis with abundant grey-blue ribbon-like elastotic fibers in upper- and mid-dermis, agglomerating to form elastic globules at places. The upper dermis shows an increased number of thin-walled capillaries and sparse superficial perivascular lymphohistiocytic infiltrate with thinning of reticular dermis [Figure 2]. We diagnosed him as a case of Favre-Racouchot syndrome (FRS) with tinea cruris. Special stains were not done as the histopathology on hematoxylin and eosin staining was characteristic of this syndrome. He was prescribed a 2-week course of twice daily terbinafine cream that completely cleared the fungal infection when examined on follow-up. He refused any treatment for the facial skin. Figure 1 Deeply wrinkled, furrowed, and atrophic facial skin with multiple comedones, papules, and nodules over the nose, cheeks, and forehead Figure 2 Histopathology from the cheek revealing sparse superficial perivascular lymphohistiocytic infiltrate with abundant grey blue ribbon like elastotic fibers in upper- and middermis, agglomerating to from elastic globules at places. Overlying epidermis is ... FRS, also referred to as senile comedones, solar comedones, and nodular elastosis with cysts and comedones, was originally described in 1932 by Favre and later reviewed in detail by Favre and Racouchot in 1951.[1] Though mostly reported in Caucasian men (with an estimated prevalence of 6% in adults older than 50 years), cases have also been reported in dark-skinned people including Indians, albeit rarely.[2] Cases occurring as early as the second decade of life have also been documented.[3] Males clearly outnumber females, presumably due to more sun-exposure and the effect of smoking. Clinically, this peculiar syndrome is characterized by a diffuse yellowish hue with the presence of large, open, black comedones symmetrically distributed on the temporal and periorbital areas, and deep wrinkles and furrows over a background of actinically damaged and atrophic skin.[3] In severely affected patients, multiple small papules, nodules and cystic lesions develop, especially involving the periocular region and the nose. Uncommonly, the lateral neck, retroauricular areas, earlobes, and forearms may also be involved. The eruption is usually bilaterally symmetrical. The differential diagnosis includes acne comedones, milia, colloid milium, syringomas, trichoepitheliomas, and sebaceous hyperplasia.[3] Conditions closely linked to FRS include cutis rhomboidalis nuchae which it often accompanies and the actinic comedonal plaque, which is considered to be a variant of FRS.[3] Other conditions reported to be associated with FRS include cutaneous myxoma, actinic keratosis, basal and squamous cell carcinoma, trichostasis spinulosa, keratoacanthoma, and eyelid papilloma.[4] Diagnosis is primarily clinical and histopathology is rarely required. However, the histologic features of FRS are very characteristic with presence of dilated pilosebaceous openings, atrophic sebaceous glands and large, round cyst-like spaces lined by a flattened epithelium and filled with layered horny material.[5] Evidence of significant solar elastosis is often present with presence of epidermal atrophy and massive basophilic degeneration of the upper dermis.[3] Vellus hair shafts, copious amounts of bacteria, sebum, and eosinophilic laminated horny material have been demonstrated within the cyst-like spaces, suggesting that they actually represent oblique histologic cuts of closed comedones rather than true infundibular cysts.[3,5] The comedones are colonized with Propionibacterium acnes, Corynebacterium acnes, Staphylococcus albus, and Malassezia yeasts. Inflammation is conspicuously absent. Though the precise pathogenesis of FRS remains unclear, implicated factors include chonic exposure to ultraviolet radiation and heavy smoking, which may act synergistically. Additionally, radiation therapy has been linked to development of FRS in at least three reported cases till now.[3,5] Measures to halt the progression of the disease include meticulous sun-protective measures like avoiding outdoors activities during peak hours of sun-exposure and the use of broad spectrum sunscreens.[4] Cessation of smoking is strongly advised. Isolated use of pharmacologic treatments or surgical techniques has so far resulted in unsatisfactory results. For best therapeutic outcome, one needs to target the solar elastosis, nodulocystic lesions, and the small as well as large comedones that require mechanical removal. Thus, combining medical and surgical treatments seems to be the best approach at present. Owing to their exfoliative and collagen remodeling properties, topical retinoids constitute the mainstay of medical treatment. Their regular use results in expulsion of small comedones and improvement in photodamaged skin. Daily oral Isotretinoin (0.05-0.1 mg/kg/day) used in conjunction with topical tretinoin has also been found effective.[3] Surgical techniques include comedone extraction, curettage, simple or multiple-stage excision, dermabrasion, and laser resurfacing.[4] The most recent addition to the therapeutic armamentarium of FRS is the combination of superpulsed carbon dioxide laser to vaporize the epidermis followed by extraction of cystic and comedonic material with a pair of forceps, with the entire procedure performed without anesthesia. After an initial encouraging outcome observed in two cases of unilateral FRS, Mavilia et al.,[6] reported excellent cosmetic results, rapid recovery, and good safety profile of this combination therapy in 50 patients of FRS with Fitzpatrick skin type III, and have suggested that it may become the treatment of choice for FRS in future. The prognosis of this condition is excellent if the patient is properly counseled and treated.

TRICHOSTASIS SPINULOSA (TS) is a relatively common but underdiagnosed disorder of hair follicles that retain successive telogen hairs. It has been described within skin lesions (secondary TS) or as an isolated finding (primary TS). Dermoscopy may help identify the characteristic hair tuft. We report 2 cases of TS. The first case involved a 23-year-old woman who presented with a long-standing history of a light-brown papule on the lower part of her back. There was a black punctum in the upper central area of the lesion (Figure 1). Dermoscopy showed a sparse pigment network, multiple commalike blood vessels that are typical of intradermal melanocytic nevi, a few peripheral vellous hairs, and a small hair tuft emerging from the central punctum (Figure 2). Histologic examination confirmed the presence of an intradermal melanocytic nevus along with dilated folliculosebaceous bunits containing several cross-sectioned hair shafts (Figure 3). The second case involved a 30-yearold man who presented with a micropapular eruption on both flanks. Dermoscopy showed multiple vellous hairs erupting through the follicles (Figure 4). Hair tufts are the result of folliculosebaceous hamartomas with multiple units around a central pore (trichofolliculomas) or retained hair shafts within follicles with infundibular keratosis (TS). Trichostasis spinulosa may appear as an isolated finding or in association with expansile nondestructive lesions that narrow hair infundibulae, such as melanocytic nevi, seborrheic keratoses, syringomas, or nodular basal cell carcinomas. Dermoscopy is helpful in diagnosing TS.

A forty-eight-year-old man presented with multiple pinhead to rice-sized papules on the face. Histopathologic examination showed a typical syringoma and dilated hair follicles containing several vellus hairs in the middle of a fibrotic stroma. We discuss the possible pathomechanism between these two conditions in the same lesion.

Trichostasis spinulosa is a relatively common but underdiagnosed disorder of the pilosebaceous follicles in which there is follicular hyperkeratosis of a dilated vellus hair follicle with retention of successive telogen hairs arranged in parallel among keratinaceous material. The condition is apparent as dark follicular plugs in the affected areas, most commonly affecting the face (nose and cheeks) or the trunk (interscapular area in particular). We describe a 33-year-old Indian man who was on haemodialysis for chronic renal failure and who developed unusually widespread trichostasis spinulosa over almost the entire body including the lower limbs over a period of 18 months.

Trichostasis spinulosa (TS) is a common but rarely diagnosed disease. For diagnosis, it's sufficient to see a bundle of vellus hair located in a keratinous sheath microscopically. In order to obtain these vellus hair settled in comedone-like openings, Standard skin surface biopsy (SSSB), a non-invasive method was chosen. It's aimed to remind the differential diagnosis of TS in treatment-resistant open comedone-like lesions and discuss the SSSB method in diagnosis. A 25-year-old female patient was admitted with a complaint of the black spots located on bilateral cheeks and nose for 12 years. In SSSB, multiple vellus hair bundles in funnel-shaped structures were observed under the microscope, and a diagnosis of 'TS' was made. After six weeks of treatment with tretinoin 0.025% and 4% erythromycin jel topically, the appearance of black macules was significantly reduced. Treatment had to be terminated due to her pregnancy, and the lesions recurred within 1 month. It's believed that TS should be considered in the differential diagnosis of treatment-resistant open comedone-like lesions, and SSSB might be an inexpensive and effective alternative method for the diagnosis of TS.

The literature rarely mentions perior postmenopausal acne. Postmenopausal acne was discovered coincidentally in older women seeking medical counseling for a variety of facial problems, including hyperpigmentation, seborrheic keratoses, large pores, trichostasis spinulosa, wrinkles, and other signs of photodamage. Epidemiological surveys are lacking, and thus the prevalence of postmenopausal acne is not known. We think it is quite common, as can be easily ascertained by questioning about breakouts. It is most frequently seen in women with thick, darker, oilier skin. On rare occasion, we encounter it in type I light-skinned, small-pored, blue-eyed, freckled Celts.