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August 2004
By Robert S. Levine, DO, and Stephen M.
Schleicher, MD
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CASE:
A 72-year-old man comes to see you about the recent onset
of "pimples" on his face. He denies any previous history of
acne or rosacea but does admit to ample chronic sun exposure.
The condition is asymptomatic and the main complaint is of
a cosmetic nature. Examination reveals multiple open and closed
comedones about both eyes accompanied by coarse wrinkles and
mottled hyperpigmentation.
WHAT IS YOUR DIAGNOSIS?
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Favre-Racouchot disease is a manifestation of actinic elastosis
occurring on heavily sun-damaged areas of the face. The periorbital
and infraorbital regions are most commonly involved. Chronic
exposure to solar radiation results in abnormal keratinization
of the pilosebaceous follicle. Cigarette smoking is a risk factor.
The eruption is noninflammatory and manifests primarily as comedones.
Treatment entails pore extraction, topical retinoid, and use
of sunscreens. |
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Dr. Levine is a family practice resident
at the Long Beach Medical Center in Long Beach, New York.
Dr. Schleicher is director of the DermDx Centers for Dermatology
of Northeastern Pennsylvania as well as Schleicher Dermatology
Associates in Bonita Springs, Florida. He is a clinical instructor
of dermatology at the Philadelphia College of Osteopathic
Medicine, at Kings College in Wilkes-Barre, Pennsylvania,
and at Arcadia University in Glenside, Pennsylvania. He is
also a member of the EMERGENCY MEDICINE editorial board.
Emerg Med 36(8):7-8, 2004
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