Dermoscopy of Trichostasis Spinulosa

Article (PDF Available)inArchives of dermatology 144(8):1088 · September 2008with71 Reads
Impact Factor: 4.79 · DOI: 10.1001/archderm.144.8.1088 · Source: PubMed
Abstract
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 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).

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Available from: Salvador J Diaz-Cano
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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;
Salvador J. Diaz-Cano, MD, PhD, FRCPath; Homerton University Hospital, London, England (Drs Pozo, Perrett, and Bull);
Churchill Hospital, Oxford, England (Dr Bowling); and King’s College Hospital, London (Dr Diaz-Cano)
T
RICHOSTASIS SPINULOSA (TS) IS A RELA-
tively common but underdiagnosed disor-
der of hair follicles that retain successive
telogen hairs. It has been described within
skin lesions (secondary TS) or as an iso-
lated finding (primary TS). Dermoscopy may help iden-
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-
ule on the lower part of her back. There was a black punc-
tum 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 me-
lanocytic 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 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-
tomas with multiple units around a central pore (tricho-
folliculomas) or retained hair shafts within follicles with
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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Comment

June 14, 2016
S.Nijalingappa Medical College & H.S.K.Hospital & Research Centre
A very well written article which cover important patterns of dermoscopy as well as clinical variants of trichostasis spinulosis.