We examined a 13-year-old girl with a ten-year history of honeycomb depressions on the right side of her face. These changes began in the middle of the cheekand extended to involve a large area between the ear and the lower lip. The patient denied preceding inflammation. There were no other cutaneous lesions or systemic complaints. There was no family history of a similar condition. Figure 1.On physical examination, the patient showed extensive, unilateral honeycomb scars, irregular in shape, about 1 to 3 mm in depth and 1 to 5 mm in size. The lesions were separated from each other by narrow ridges of normal-appearing skin. There were many small comedones and milia in the depressed areas (Fig 1).A 4-mm punch biopsy specimen was taken from a representative area and is shown in Figs 2 and 3. Figure 2. HISTOPATHOLOGIC FINDINGSThe biopsy specimen showed follicular plugging with perivascular infiltration of mononuclear cells in the papillary dermis. Fibroblast proliferation and focal calcification was also evident (Fig 2). On higher magnification, extensive follicular plugging and double comedo formation can be seen (Fig 3).
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