Trichostasis Spinulosa

Author: Stephen J Krivda, MD; Chief Editor: Dirk M Elston, MD more...

Updated: Jun 7, 2010

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Background
Pathophysiology
Epidemiology
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Background

In trichostasis spinulosa (TS), clusters of vellus hairs become embedded within hair follicles, with resultant elevated, dark, spiny papules on the face or trunk. Trichostasis spinulosa frequently is discovered as an incidental finding, and often it is confused with keratosis pilaris or acne comedones.

Pathophysiology

Trichostasis spinulosa results from successive production and retention of vellus telogen club hairs from a single hair matrix in a follicle. Hyperkeratosis plugs the follicle and results in the retention of the vellus hairs in the obstructed follicular infundibulum. The precise cause of this phenomenon remains undetermined.

Frequency

United States

To the authors' knowledge, studies of prevalence have not been undertaken, but published reports indicate that the condition is common, especially in elderly persons.

Mortality/Morbidity

Trichostasis spinulosa is primarily a cosmetic concern. Trichostasis spinulosa does not cause morbidity. The condition may become more severe with age.

Sex

Most reports state that trichostasis spinulosa more frequently affects male patients, but it may occur equally in men and women.

Age

Rarely, cases are reported in children, but the condition nearly always occurs in adults, especially older adults.

Proceed to Clinical Presentation

Contributor Information and Disclosures

Author

Stephen J Krivda, MD Assistant Professor of Dermatology, Uniformed Services University of the Health Sciences; Chief of the Integrated Department of Dermatology, Chief of Dermatology Service, Director of Dermatopathology, Staff Dermatopathologist, Walter Reed Army Medical Center; Head, Department of Dermatology, Staff Dermatologist and Dermatopathologist, National Naval Medical Center

Stephen J Krivda, MD is a member of the following medical societies: American Academy of Dermatology, American Society of Dermatopathology, Association of Military Dermatologists, and Phi Beta Kappa

Disclosure: Nothing to disclose.

Coauthor(s)

George E vonHilsheimer, MD Assistant Professor of Dermatology, Uniformed Services University of the Health Sciences; Chief, Staff Dermatologist, Department of Medicine, Martin Army Community Hospital, Fort Benning, Georgia

George E vonHilsheimer, MD is a member of the following medical societies: American Academy of Dermatology, American Medical Association, and Association of Military Dermatologists

Disclosure: Nothing to disclose.

Specialty Editor Board

Leonard Sperling, MD Chair, Professor, Department of Dermatology, Uniformed Services University of the Health Sciences

Leonard Sperling, MD is a member of the following medical societies: American Academy of Dermatology

Disclosure: Nothing to disclose.

Michael J Wells, MD Associate Professor, Department of Dermatology, Texas Tech University Health Sciences Center

Michael J Wells, MD is a member of the following medical societies: Alpha Omega Alpha, American Academy of Dermatology, American Medical Association, and Texas Medical Association

Disclosure: Nothing to disclose.

Lester F Libow, MD Dermatopathologist, South Texas Dermatopathology Laboratory

Lester F Libow, MD is a member of the following medical societies: American Academy of Dermatology, American Society of Dermatopathology, and Texas Medical Association

Disclosure: Nothing to disclose.

Catherine M Quirk, MD Clinical Assistant Professor, Department of Dermatology, University of Pennsylvania

Catherine M Quirk, MD is a member of the following medical societies: Alpha Omega Alpha and American Academy of Dermatology

Disclosure: Nothing to disclose.

Chief Editor

Dirk M Elston, MD Director, Department of Dermatology, Geisinger Medical Center

Dirk M Elston, MD is a member of the following medical societies: American Academy of Dermatology

Disclosure: Nothing to disclose.

References

Sidwell RU, Francis N, Bunker CB. Diffuse trichostasis spinulosa in chronic renal failure. Clin Exp Dermatol. Jan 2006;31(1):86-8. [Medline].
Janjua SA, McKoy KC, Iftikhar N. Trichostasis spinulosa: possible association with prolonged topical application of clobetasol propionate 0.05% cream. Int J Dermatol. Sep 2007;46(9):982-5. [Medline].
Harford RR, Cobb MW, Miller ML. Trichostasis spinulosa: a clinical simulant of acne open comedones. Pediatr Dermatol. Nov-Dec 1996;13(6):490-2. [Medline].
Pozo L, Bowling J, Perrett CM, Bull R, Diaz-Cano SJ. Dermoscopy of trichostasis spinulosa. Arch Dermatol. Aug 2008;144(8):1088. [Medline].
Elston DM, White LC. Treatment of trichostasis spinulosa with a hydroactive adhesive pad. Cutis. Jul 2000;66(1):77-8. [Medline].
Manuskiatti W, Tantikun N. Treatment of trichostasis spinulosa in skin phototypes III, IV, and V with an 800-nm pulsed diode laser. Dermatol Surg. Jan 2003;29(1):85-8. [Medline].
Toosi S, Ehsani AH, Noormohammadpoor P, Esmaili N, Mirshams-Shahshahani M, Moineddin F. Treatment of trichostasis spinulosa with a 755-nm long-pulsed alexandrite laser. J Eur Acad Dermatol Venereol. Sep 23 2009;[Medline].

Small, dark, follicular papules on the nose.

Biopsy specimen demonstrates a dilated follicle that contains numerous vellus hairs and keratin debris.

Potassium hydroxide mount of an extracted plug reveals multiple vellus hairs embedded in keratinous material.

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