Favre-Racouchot Syndrome (Nodular Elastosis With Cysts and Comedones) Treatment & Management
- Author: Robert P Feinstein, MD; Chief Editor: Dirk M Elston, MD more...
Sun protection may be of benefit in preventing progression. Advise the patient to avoid sun exposure, particularly between 10:00 am and 2:00 pm. Select sunscreen to provide good protection throughout the UV-A and UV-B range. Sunscreens containing micropulverized titanium dioxide or Parsol 1789 provide the best protection throughout the UV-A range. Smoking cessation also is critical. Application of topical retinoids including tretinoin, adapalene, or tazarotene in various bases will loosen the comedones and assist in the extraction of individual comedones.
Comedo extraction is effective. However, these comedones are more difficult to extract than are those seen in acne vulgaris. The concomitant use of topical retinoids assists in the extraction process.
Dermabrasion of the affected area has been reported to produce variable cosmetic results.
The comedones can be removed via careful curettage with good cosmetic results.
Chemical peels, laser peels, and staged excision of the involved area have been reported, but the cosmetic result is highly variable.
Treatment with carbon dioxide laser has been reported. Mavilia et al evaluated 50 patients with a superpulsed carbon dioxide laser in an attempt to vaporize epidermis. They then extracted both cystic and comedonal material via soft pressure with a pair of forceps. The laser treatment was performed without topical or intralesional anesthetics, as no pain was reported using the laser parameters they described. The technique proved to be safe and effective in all of the patients treated, assuring an excellent cosmetic result. Rai et al, using a similar approach, confirmed these findings.
Favre M. Sur une kystique des appareils pilo-sebaces localis ertaines r'ons de la face. Bull Soc Fr Dermatol Syph. 1932. 39:93-6.
Favre M, Racouchot J. [Nodular cutaneous elasteidosis with cysts and comedones.]. Ann Dermatol Syphiligr (Paris). 1951 Nov-Dec. 78(6):681-702. [Medline].
Patterson WM, Fox MD, Schwartz RA. Favre-Racouchot disease. Int J Dermatol. 2004 Mar. 43(3):167-9. [Medline].
Cardoso F, Nakandakari S, Zattar GA, Soares CT. Actinic comedonal plaque-variant of Favre-Racouchot syndrome: report of two cases. An Bras Dermatol. 2015 Jun. 90 (3 Suppl 1):185-7. [Medline].
Keough GC, Laws RA, Elston DM. Favre-Racouchot syndrome: a case for smokers' comedones. Arch Dermatol. 1997 Jun. 133(6):796-7. [Medline].
Vogel S, Muhlstadt M, Molin S, Ruzicka T, Schneider J, Herzinger T. Unilateral favre-racouchot disease: evidence for the eiological role of chronic solar damage. Dermatology. 2013. 226:32-4. [Medline].
Breit S, Flaig MJ, Wolff H, Plewig G. Favre-Racouchot-like disease after radiation therapy. J Am Acad Dermatol. 2003 Jul. 49(1):117-9. [Medline].
Friedman SJ, Su WP. Favre-Racouchot syndrome associated with radiation therapy. Cutis. 1983 Mar. 31(3):306-10. [Medline].
Hoff NP, Reifenberger J, Boike E, Homey B, Gerber PA. Radiation-induced Favre-Racouchot disease. Hautarzt. Oct., 2012. 10:766-7. [Medline].
Lim HW, James WD, Rigel DS, Maloney ME, Spencer JM, Bhushan R. Adverse effects of ultraviolet radiation from the use of indoor tanning equipment: time to ban the tan. J Am Acad Dermatol. 2011 May. 64(5):893-902. [Medline].
Adams BB, Chetty VB, Mutasim DF. Periorbital comedones and their relationship to pitch tar: a cross-sectional analysis and a review of the literature. J Am Acad Dermatol. 2000 Apr. 42(4):624-7. [Medline].
Morgan MB, Stevens GL, Somach S. Multiple follicular cysts, infundibular type with vellus hairs and solar elastosis of the ears: a new dermatoheliosis?. J Cutan Pathol. 2003 Jan. 30(1):29-31. [Medline].
Lewis KG, Bercovitch L, Dill SW, Robinson-Bostom L. Acquired disorders of elastic tissue: part I. Increased elastic tissue and solar elastotic syndromes. J Am Acad Dermatol. 2004 Jul. 51(1):1-21; quiz 22-4. [Medline].
Sanchez-Yus E, del Rio E, Simon P, Requena L, Vazquez H. The histopathology of closed and open comedones of Favre-Racouchot disease. Arch Dermatol. 1997 Jun. 133(6):743-5. [Medline].
Kligman AM, Plewig G, Mills OH Jr. Topically applied tretinoin for senile (solar) comedones. Arch Dermatol. 1971 Oct. 104(4):420-1. [Medline].
Sharkey MJ, Keller RA, Grabski WJ, McCollough ML. Favre-Racouchot syndrome. A combined therapeutic approach. Arch Dermatol. 1992 May. 128(5):615-6. [Medline].
English DT, Martin GC, Reisner JE. Dermabrasion for nodular cutaneous elastosis with cysts and comedones. Favre-Racouchot syndrome. Arch Dermatol. 1971 Jul. 104(1):92-3. [Medline].
Mohs FE, McCall MW, Greenway HT. Curettage for removal of the comedones and cysts of the Favre-Racouchot syndrome. Arch Dermatol. 1982 May. 118(5):365-6. [Medline].
Mavilia L, Campolmi P, Santoro G, Lotti T. Combined treatment of Favre-Racouchot syndrome with a superpulsed carbon dioxide laser: report of 50 cases. Dermatol Ther. 2010 Jan-Feb. 23 Suppl 1:S4-6. [Medline].
Rai S, Madan V, August PJ, Ferguson JE. Favre Racouchot Syndrome; A novel two- step treatment approach using the carbon dioxide laser. Br J Dermatol. Nov 2013. [Full Text].