SECTION EDITOR: JAMES M. GRICHNIK, MD, PhD; ASSISTANT SECTION EDITORS: ASHFAQ A. MARGHOOB, MD; ALON SCOPE, MD
Dermoscopy of Trichostasis Spinulosa
Lucia Pozo, MD, PhD; Jonathan Bowling, FRCP; Conal M. Perrett, MRCP; Richard Bull, FRCP;
Churchill Hospital, Oxford, England (Dr Bowling); and King’s College Hospital, London (Dr Diaz-Cano)
tify the characteristic hair tuft. We report 2 cases of TS.
The first case involved a 23-year-old woman who pre-
sented with a long-standing history of a light-brown pap-
tum in the upper central area of the lesion (Figure 1).
Dermoscopy showed a sparse pigment network, multiple
lanocytic nevi, a few peripheral vellous hairs, and a small
RICHOSTASIS SPINULOSA (TS) IS A RELA-
der of hair follicles that retain successive
skin lesions (secondary TS) or as an iso-
lated finding (primary TS). Dermoscopy may help iden-
hair tuft emerging from the central punctum (Figure 2).
Histologic examination confirmed the presence of an in-
tradermal melanocytic nevus along with dilated folliculo-
sebaceous units containing several cross-sectioned hair
shafts (Figure 3). The second case involved a 30-year-
old 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 hamar-
infundibular keratosis (TS). Trichostasis spinulosa may
appear as an isolated finding or in association with ex-
pansile nondestructive lesions that narrow hair infun-
dibulae, such as melanocytic nevi, seborrheic keratoses,
syringomas, or nodular basal cell carcinomas. Dermos-
copy is helpful in diagnosing TS.
Figure 1. Intradermal nevus revealing a central punctum.
Figure 2. Dermoscopic examination shows a hair tuft corresponding to the
dark punctum (original magnification ?10 [inset, ?15]).
Figure 3. Histologically, an intradermal melanocytic nevus was observed,
revealing multiple hair shafts in a central dilated follicle (hematoxylin-eosin,
original magnification ?200).
Figure 4. Dermoscopic image of multiple hair shafts emerging from a dilated
pore (original magnification ?10).
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