Traumatic Anserine Folliculosis and Comedones

Abstract

Traumatic anserine folliculosis (TAF) is an under-recognized and under-reported entity that is commonly mistaken as comedonal acne. It is seen in children and young adults and friction has been implicated as a probable factor in its causation. As face is the commonest site, biopsy may not be a feasible diagnostic option. Dermoscopy proves to be a reliable non-invasive diagnostic tool to differentiate these two disorders. In this article, we describe the dermoscopic features of TAF in three patients and also attempt to highlight the clinical and dermoscopic distinction between TAF and comedonal acne.

Lichenified plaque in chin after chronic irritation

“…Although follicular plugging is seen with TAF, white scale and a pale pink zone at the periphery are seen with comedonal acne. 5 Dilatation of follicular openings, follicular plugs, perifollicular scale, and embedded hair in follicles – Correct. Dermoscopy of TAF may reveal dilated follicular canals filled with massive hyperkeratotic plugs/follicular spicules and few hair shafts.…”

“…Although inflammation is not thought to be involved in the etiology of TAF, it may be present in some cases, appearing as reddish-brownish discoloration of the surrounding skin on dermoscopic examination. 5 Aggregated white-yellow globules surrounded by crown vessels – Incorrect. Aggregated white-yellow globules, also known as the “cumulus sign,” surrounded by bending blood vessels with central extension are findings seen in the diagnosis of sebaceous hyperplasia.…”

“…Although follicular plugging is seen with TAF, white scale and a pale pink zone at the periphery are seen with comedonal acne. 5 …”

“…Although inflammation is not thought to be involved in the etiology of TAF, it may be present in some cases, appearing as reddish-brownish discoloration of the surrounding skin on dermoscopic examination. 5 …”