Clinicopathological Study of 12 Cases of Erythromelanosis Follicularis Faciei et Colli

Jang, Ho Sun; Lee, Chea Wook; Cha, Jung Hoon; Kim, Sung Jun; Oh, Chang Keun; Kwon, Kyung Sool

Abstract

BACKGROUND: Erythromelanosis follicularis faciei et colli(EFFC) is an infrequently diagnosed disorder. This condition consists of the clincal triad of well-demarcated erythema, hyperpigmentation, and follicular plugging on the face and neck. The etiology of EFFC remains obscure, and therapy for EFFC is only moderately successful.
OBJECTIVE
The aim of this study is to examine the clinical and histopathologic findings of erythromelanosis follicularis faciei et colli and suggest the new treatment method of erythema by 585nm flashlamp-pumped dye laser.
METHODS
We evaluated 12 patients of erythromelanosis follicularis faciei et colli. Among them, we made a trial of 585nm flashlamp-pumped dye laser in erythema of EFFC on 11 cases.
RESULTS
The results were as follows; 1. The mean age of onset and that of the first visits made by patients was 12.1 and 18.9 years, respectively, and there was a male predominance. 2. Histologic features revealed hyperpigmentation in basal layer, perivascular and periadnexal lymphocytic infiltration, and vessel dilatation in upper dermis in all specimens. Follicular plugging(62.5%), hyperkeratosis without parakeratosis(55.6%), enlarged hair follicle containing lamellar body(25.0%), and sebaceous gland hypertrophy(22.2%) were also observed. 3. Electron microscopic studies showed abnormal melanosomes, such as a stippled appearance of the periphery of a melanosome and a large number in the cytoplasm of basal cells. 4. 585nm flashlamp-pumped dye laser treatment with fluences that ranged from 6.5-7.5J/cm2 was given on 1 time. In 2 cases, results were achieved in fair improvement of erythema. Hyperpigmentation occurred in 2 cases(2/11) .
CONCLUSION
Characteristically, EFFC affects adolescent males predominantly. The histologic features, although nondiagnostic, correlate with the clinical features. We suggest the new treatment modality, 585nm flashlamp-pumped dye laser, for the treatment of erythema in EFFC. EFFC, which can cause significant cosmetic problems to patients, maybe much more common than recognized. However, it is not well known, may be because the small number of cases have been reported in the literature. It can be helpful to understand the pathogenesis and improve treatment modalities when it will be recognized by more physicians and patients.