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Favre-Racouchot Syndrome (Nodular Elastosis With Cysts and Comedones) Clinical Presentation

  • Author: Robert P Feinstein, MD; Chief Editor: Dirk M Elston, MD  more...
Updated: Sep 08, 2015


The patient will relate considerable sun exposure over a long period of time. Heavy smoking is also associated with Favre-Racouchot syndrome. Rarely, the patient will mention a past experience of radiation therapy.



Multiple open and closed comedones are present in the periorbital and temporal areas. Rarely, the lateral neck, postauricular areas, and forearms may be involved. Severely actinic damaged skin with yellowish discoloration, yellowish nodules, atrophy, wrinkles, and furrows are present. The eruption is usually bilaterally symmetrical, although one side may predominate, particularly if that side experienced greater sun exposure. No inflammation is present, unlike the comedones seen in acne vulgaris.[3]

An actinic comedonal plaque-variant of Favre-Racouchot syndrome has been described. This variant presents with papules, cysts, and comedones producing a yellowish plaque in areas of chronic sun-damaged skin. Two cases from Brazil are presented. The involvement is usually on the forearms and chest, with UV light exposure being the main factor in its pathogenesis.[4]




Although the precise pathogenesis of the disorder is unknown, it develops in individuals with a heavy smoking history and chronic exposure to UV light.[5] Recently, Vogel et al described a case of unilateral Favre-Racouchot syndrome indicating the etiologic role of chronic solar damage in this disease.[6]

The disorder also may follow exposure to radiation therapy.[7, 8] This was illustrated in a paper by Hoff et al, in which a 71-year-old man treated with radiation therapy for a malignant melanoma of the right paranasal sinus. He subsequently developed elastosis, open and closed comedones, and cysts in the radiation field.[9]

Lim et al, in a discussion of the adverse effects of UV radiation from the use of indoor tanning equipment, has cited Favre-Racouchot syndrome as one of these adverse effects.[10]

Contributor Information and Disclosures

Robert P Feinstein, MD Associate Clinical Professor, Department of Dermatology, Columbia University College of Physicians and Surgeons

Robert P Feinstein, MD is a member of the following medical societies: American Academy of Dermatology, American Medical Association, Noah Worcester Dermatological Society, Phi Beta Kappa

Disclosure: Nothing to disclose.

Specialty Editor Board

Francisco Talavera, PharmD, PhD Adjunct Assistant Professor, University of Nebraska Medical Center College of Pharmacy; Editor-in-Chief, Medscape Drug Reference

Disclosure: Received salary from Medscape for employment. for: Medscape.

Edward F Chan, MD Clinical Assistant Professor, Department of Dermatology, University of Pennsylvania School of Medicine

Edward F Chan, MD is a member of the following medical societies: American Academy of Dermatology, American Society of Dermatopathology, Society for Investigative Dermatology

Disclosure: Nothing to disclose.

Chief Editor

Dirk M Elston, MD Professor and Chairman, Department of Dermatology and Dermatologic Surgery, Medical University of South Carolina College of Medicine

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

Disclosure: Nothing to disclose.

Additional Contributors

Andrea Leigh Zaenglein, MD Professor of Dermatology and Pediatrics, Department of Dermatology, Hershey Medical Center, Pennsylvania State University College of Medicine

Andrea Leigh Zaenglein, MD is a member of the following medical societies: American Academy of Dermatology, Society for Pediatric Dermatology

Disclosure: Received consulting fee from Galderma for consulting; Received consulting fee from Valeant for consulting; Received consulting fee from Promius for consulting; Received consulting fee from Anacor for consulting; Received grant/research funds from Stiefel for investigator; Received grant/research funds from Astellas for investigator; Received grant/research funds from Ranbaxy for other; Received consulting fee from Ranbaxy for consulting.

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