Trichostasis Spinulosa: A Case Report with an Unusual Presentation

Case Reports in Dermatology
12 Jan, 2021 ,

Chaninan Kositkuljorn presented a case of a 57-year-old male with an unusual location of Trichostasis spinulosa. Trichostasis spinulosa is considered as a common disorder; however, it is often underdiagnosed due to its asymptomatic nature. Although the condition frequently affects the face or extremities, the widespread distribution of Trichostasis spinulosa over the entire body has been once reported in a patient with chronic renal failure. 

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A 57-year-old male patient visited an outpatient dermatology clinic for the treatment of chronic eczema. Apart from the chief complaint, numerous dark-brownish keratotic follicular papules were noticed at the entire back without being concerned by the patient. He reported that the lesions at the back developed since his teenage years without any symptoms. None of his family members had similar lesions. He denied waxing, scrubbing, or applying any topical medications. The dermoscopic examination demonstrated a bundle of short, multiple hairs surrounded by a keratinous sheath in a dilated follicle.

Skin biopsy was performed at a representative area, which revealed follicular hyperkeratosis with dilated infundibulum containing a group of vellus hair shafts. Based on the history, clinical presentation, and histopathological findings, the diagnosis was consistent with TS. His treatment comprised twice-daily 10% urea cream applied on the lesions, and mild improvement was shown at a 4-week follow-up visit.