Trichostasis Spinulosa Workup

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

Updated: Jun 7, 2010

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Laboratory Studies
Other Tests
Histologic Findings
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Laboratory Studies

The diagnosis of trichostasis spinulosa (TS) can be made clinically without obtaining a biopsy specimen. If the diagnosis is in doubt, a specimen may easily be obtained by removing a hair plug with a forceps or comedone extractor. The specimen should be placed on a glass slide and covered for examination.

Other Tests

Dermoscopy may also be used to help confirm the diagnosis.^[4]

Histologic Findings

Treatment with potassium hydroxide dissolves the keratinous plug, leaving numerous vellus hairs in a characteristic tuft. If a biopsy specimen is obtained, microscopic examination reveals a dilated hair follicle with hyperkeratosis and acanthosis of the follicular epithelium (see the images below). Inflammatory changes are not a characteristic of trichostasis spinulosa.

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.

Proceed to Treatment & Management

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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