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

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

Laboratory Studies

The clinical findings of multiple open and closed comedones with yellowish nodules of elastotic material in a middle-aged to elderly individual are sufficient to establish the diagnosis. In the absence of elastotic nodules, the differential diagnosis includes chloracne. History and porphyrin studies could be helpful.

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Histologic Findings

The lesions appear identical to the comedones seen in acne vulgaris. However, the surrounding dermis contains significant actinic elastosis, including nodules of elastin. Although the disorder has been described as containing cysts, many of the apparent cysts really are nodules of elastotic material.[10] Gram-positive bacteria that stain periodic acid-Schiff positive have been noted.[11] The bacteria are probably Propionibacterium acnes. Hair shafts may or may not be found within the comedones.

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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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