DISCUSSION
These changes represent Favre-Racouchot syndrome (FRS). First described by Favre in 1932, the syndrome was refined in 1951 when Favre and Racouchot noticed its prevalence in truck drivers who also smoked. In France at that time, more than 80% of truck drivers were smokers—and they got the most sun exposure on the left sides of their faces. The condition was later identified in fishermen and other outdoor workers.
Studies in the US show that FRS affects nearly 6% of white adults (usually men) older than 60. Radiation therapy (eg, for squamous cell carcinoma) can produce similar effects.
Needless to say, smoking cessation is advisable. Beyond that, treatment involves preventing further sun damage and applying retinoid preparations, such as tretinoin or adapalene. Depending on the desired level of improvement, comedones may need to be surgically ablated.
TAKE-HOME LEARNING POINTS
• Favre-Racouchot syndrome (FRS) manifests with collections of open and closed comedones on sun-damaged facial skin.
• Most FRS patients are white male smokers older than 60.
• FRS is usually unilateral, resulting from overexposure to sunlight through a vehicle’s driver-side window; however, people working outdoors (eg, fishermen) can develop it over the whole face.