Favre-Racouchot Syndrome (Nodular Elastosis With Cysts and Comedones) Treatment & Management

  • Author: Robert P Feinstein, MD; Chief Editor: Dirk M Elston, MD   more...
 
Updated: Jul 1, 2011
 

Medical Care

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,[12] adapalene, or tazarotene in various bases will loosen the comedones and assist in the extraction of individual comedones.

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Surgical Care

Comedo extraction is effective. However, these comedones are more difficult to extract than are those seen in acne vulgaris. Note the following:

  • The concomitant use of topical retinoids assists in the extraction process.[13]
  • Dermabrasion of the affected area has been reported to produce variable cosmetic results.[14]
  • The comedones can be removed via careful curettage with good cosmetic results.[15]
  • 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.
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Contributor Information and Disclosures
Author

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, and Phi Beta Kappa

Disclosure: Nothing to disclose.

Specialty Editor Board

James W Patterson, MD  Professor of Pathology and Dermatology, Director of Dermatopathology, University of Virginia Medical Center

James W Patterson, MD is a member of the following medical societies: American Academy of Dermatology, American College of Physicians, American Society of Dermatopathology, Royal Society of Medicine, Society for Investigative Dermatology, and United States and Canadian Academy of Pathology

Disclosure: Nothing to disclose.

David F Butler, MD  Professor of Dermatology, Texas A&M University College of Medicine; Chair, Department of Dermatology, Director, Dermatology Residency Training Program, Scott and White Clinic, Northside Clinic

David F Butler, MD is a member of the following medical societies: Alpha Omega Alpha, American Academy of Dermatology, American Medical Association, American Society for Dermatologic Surgery, American Society for MOHS Surgery, Association of Military Dermatologists, and Phi Beta Kappa

Disclosure: Nothing to disclose.

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, and Society for Investigative Dermatology

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, Ackerman Academy of Dermatopathology, New York

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

Disclosure: Nothing to disclose.

References

  1. 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.

  2. Favre M, Racouchot J. [Nodular cutaneous elasteidosis with cysts and comedones.]. Ann Dermatol Syphiligr (Paris). Nov-Dec 1951;78(6):681-702. [Medline].

  3. Keough GC, Laws RA, Elston DM. Favre-Racouchot syndrome: a case for smokers' comedones. Arch Dermatol. Jun 1997;133(6):796-7. [Medline].

  4. Patterson WM, Fox MD, Schwartz RA. Favre-Racouchot disease. Int J Dermatol. Mar 2004;43(3):167-9. [Medline].

  5. Breit S, Flaig MJ, Wolff H, Plewig G. Favre-Racouchot-like disease after radiation therapy. J Am Acad Dermatol. Jul 2003;49(1):117-9. [Medline].

  6. Friedman SJ, Su WP. Favre-Racouchot syndrome associated with radiation therapy. Cutis. Mar 1983;31(3):306-10. [Medline].

  7. 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. May 2011;64(5):893-902. [Medline].

  8. 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. Apr 2000;42(4):624-7. [Medline].

  9. 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. Jan 2003;30(1):29-31. [Medline].

  10. 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. Jul 2004;51(1):1-21; quiz 22-4. [Medline].

  11. 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. Jun 1997;133(6):743-5. [Medline].

  12. Kligman AM, Plewig G, Mills OH Jr. Topically applied tretinoin for senile (solar) comedones. Arch Dermatol. Oct 1971;104(4):420-1. [Medline].

  13. Sharkey MJ, Keller RA, Grabski WJ, McCollough ML. Favre-Racouchot syndrome. A combined therapeutic approach. Arch Dermatol. May 1992;128(5):615-6. [Medline].

  14. English DT, Martin GC, Reisner JE. Dermabrasion for nodular cutaneous elastosis with cysts and comedones. Favre-Racouchot syndrome. Arch Dermatol. Jul 1971;104(1):92-3. [Medline].

  15. Mohs FE, McCall MW, Greenway HT. Curettage for removal of the comedones and cysts of the Favre-Racouchot syndrome. Arch Dermatol. May 1982;118(5):365-6. [Medline].

  16. Jansen T, Plewig G. Favre-Racouchot Syndrome. Clin Dermatol. 1975;Unit 4-44:1-4.

  17. Plewig G, Kligman AM. Acne and Rosacea. Munich, Germany: Universitat Munchen; 1993:79-81, 83, 93, 97, 113, 119, 121, 129, 396.

 
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