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A 56-year-old woman has several lesions she is worried might be cancerous. Added to that, there have been changes to her facial skin over the past several years that are increasingly obvious to her friends and family and therefore concerning to the patient.
She has an extensive history of nonmelanoma skin cancers, including basal cell carcinomas and squamous cell carcinomas, which were removed from her trunk in the distant past. She has lived in the southwestern United States all her life and has been smoking cigarettes since age 14.
EXAMINATION
The patient’s skin is quite fair, with abundant evidence of sun damage. She looks considerably older than her stated age.
Fortunately, no skin cancers are found on examination, but many closed and open comedones can be seen on both of her cheeks, stippled on rough, weathered skin. Solar elastosis manifests in this area as diffuse white thickening—what some might call “chicken skin.”
What is the diagnosis?
Favre-Racouchot syndrome (FRS) is a fairly common result of chronic overexposure to UV sources; it is especially prevalent among men who smoke. For reasons not fully understood, the changes associated with FRS tend to be relegated to the bilateral malar cheeks, roughly even with the eyes. Apart from the patient being female, this case is quite typical.
Chronic overexposure to UV light is known to result in dermatologic changes such as solar elastosis and the aforementioned whitish plaques—which, on microscopic exam, are simply basophilic degeneration of the dermis. This degeneration can be seen all over the face, but it is particularly evident on the forehead and cheeks; the concentration of comedones on the cheeks is unique to FRS.
Treatment options include lasers and peels, which involve considerable expenditure of time and money. While the comedones can be extracted, they are likely to recur unless more invasive methods are used.
TAKE-HOME LEARNING POINTS
- Favre-Racouchot syndrome (FRS) is seen primarily in men with chronic overexposure to sunlight—particularly those who smoke.
- FRS is characterized by localized collections of open and closed comedones superimposed on thickened, white “chicken skin” (solar elastosis).
- These changes typically occur on the bilateral cheeks of patients in the later decades of life, though they have been seen on patients in their 20s.
- Treatment is possible by means of laser resurfacing and/or chemical peels.
A 56-year-old woman has several lesions she is worried might be cancerous. Added to that, there have been changes to her facial skin over the past several years that are increasingly obvious to her friends and family and therefore concerning to the patient.
She has an extensive history of nonmelanoma skin cancers, including basal cell carcinomas and squamous cell carcinomas, which were removed from her trunk in the distant past. She has lived in the southwestern United States all her life and has been smoking cigarettes since age 14.
EXAMINATION
The patient’s skin is quite fair, with abundant evidence of sun damage. She looks considerably older than her stated age.
Fortunately, no skin cancers are found on examination, but many closed and open comedones can be seen on both of her cheeks, stippled on rough, weathered skin. Solar elastosis manifests in this area as diffuse white thickening—what some might call “chicken skin.”
What is the diagnosis?
Favre-Racouchot syndrome (FRS) is a fairly common result of chronic overexposure to UV sources; it is especially prevalent among men who smoke. For reasons not fully understood, the changes associated with FRS tend to be relegated to the bilateral malar cheeks, roughly even with the eyes. Apart from the patient being female, this case is quite typical.
Chronic overexposure to UV light is known to result in dermatologic changes such as solar elastosis and the aforementioned whitish plaques—which, on microscopic exam, are simply basophilic degeneration of the dermis. This degeneration can be seen all over the face, but it is particularly evident on the forehead and cheeks; the concentration of comedones on the cheeks is unique to FRS.
Treatment options include lasers and peels, which involve considerable expenditure of time and money. While the comedones can be extracted, they are likely to recur unless more invasive methods are used.
TAKE-HOME LEARNING POINTS
- Favre-Racouchot syndrome (FRS) is seen primarily in men with chronic overexposure to sunlight—particularly those who smoke.
- FRS is characterized by localized collections of open and closed comedones superimposed on thickened, white “chicken skin” (solar elastosis).
- These changes typically occur on the bilateral cheeks of patients in the later decades of life, though they have been seen on patients in their 20s.
- Treatment is possible by means of laser resurfacing and/or chemical peels.
A 56-year-old woman has several lesions she is worried might be cancerous. Added to that, there have been changes to her facial skin over the past several years that are increasingly obvious to her friends and family and therefore concerning to the patient.
She has an extensive history of nonmelanoma skin cancers, including basal cell carcinomas and squamous cell carcinomas, which were removed from her trunk in the distant past. She has lived in the southwestern United States all her life and has been smoking cigarettes since age 14.
EXAMINATION
The patient’s skin is quite fair, with abundant evidence of sun damage. She looks considerably older than her stated age.
Fortunately, no skin cancers are found on examination, but many closed and open comedones can be seen on both of her cheeks, stippled on rough, weathered skin. Solar elastosis manifests in this area as diffuse white thickening—what some might call “chicken skin.”
What is the diagnosis?
Favre-Racouchot syndrome (FRS) is a fairly common result of chronic overexposure to UV sources; it is especially prevalent among men who smoke. For reasons not fully understood, the changes associated with FRS tend to be relegated to the bilateral malar cheeks, roughly even with the eyes. Apart from the patient being female, this case is quite typical.
Chronic overexposure to UV light is known to result in dermatologic changes such as solar elastosis and the aforementioned whitish plaques—which, on microscopic exam, are simply basophilic degeneration of the dermis. This degeneration can be seen all over the face, but it is particularly evident on the forehead and cheeks; the concentration of comedones on the cheeks is unique to FRS.
Treatment options include lasers and peels, which involve considerable expenditure of time and money. While the comedones can be extracted, they are likely to recur unless more invasive methods are used.
TAKE-HOME LEARNING POINTS
- Favre-Racouchot syndrome (FRS) is seen primarily in men with chronic overexposure to sunlight—particularly those who smoke.
- FRS is characterized by localized collections of open and closed comedones superimposed on thickened, white “chicken skin” (solar elastosis).
- These changes typically occur on the bilateral cheeks of patients in the later decades of life, though they have been seen on patients in their 20s.
- Treatment is possible by means of laser resurfacing and/or chemical peels.