Favre-Racouchot disease
Definition & Cause
- Favre-Racouchot disease (nodular cutaneous elastosis with cysts and comedones) = a consequence of chronic UV damage: solar elastosis with numerous open and closed comedones and small cysts in photodamaged facial skin.
- The decisive sentence: The black dots in Favre-Racouchot disease are solar comedones caused by chronic UV damage, not an expression of acne.
- Who is affected: older people with many years of cumulative sun exposure; men more often than women. Smoking is regarded as an additional contributing factor.
- Why "elastoidosis nodularis et cystica": the old name describes exactly what is seen — nodular-cystic remodelled, elastotic skin.
Clinical Presentation
- Sites: Sites of predilection are periorbital, temple and zygomatic region, i.e. the light-exposed surfaces.
- Lesions: numerous open comedones ("blackheads"; the colour comes from oxidised keratin in the widened follicular ostium), plus closed comedones and small cysts.
- The background: yellowish thickened skin with coarse pores and a coarsened wrinkle pattern — this is the solar elastosis itself. Alongside it, solar lentigines from the same cause are regularly present.
- What is missing: Against acne speaks the complete absence of inflammatory papules and pustules.
- Symptoms: none. It does not itch and does not hurt — patients come because of the appearance, or the finding is noticed incidentally.
Histology
- Pronounced solar elastosis of the upper and mid dermis, together with markedly dilated follicular infundibula filled with lamellar keratin; cystically dilated follicular segments. Signs of inflammation are typically absent.
Differential diagnoses
- Acne comedonica
- Milia (milium)
- Sebaceous hyperplasia
- Epidermoid cyst
- Seborrhoeic keratosis
- Acne vulgaris
- Actinic keratosis
- Solar lentigo
Practise Favre-Racouchot disease in the app
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In the DermaFuchs app: 2 flashcards · 3 clinical images
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