Ulerythema Clinical Presentation

Updated: May 23, 2019
  • Author: Camila K Janniger, MD; Chief Editor: Dirk M Elston, MD  more...
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Presentation

History

The parents usually note erythema and tiny keratotic papules on the lateral parts of the eyebrows during early childhood. Similar lesions may develop on the lateral aspects of the front and on the cheeks. Later, atrophy and loss of eyebrows may ensue. Sometimes, discrete follicular papules appear; follicular papules may also be present on the extensor sites of the arms and the thighs.

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Physical Examination

Erythema with slight follicular hyperkeratosis appears on the cheeks and lateral aspects of the eyebrows. The scalp may also be involved. The affected areas may feel rough on delicate palpation.

A generalized facial erythema with scattered open and closed comedones and milia may be present. Rarely, similar lesions may be seen on the extensor surfaces of the arms and legs.

Hyperkeratotic follicular plugs with surrounding erythema that eventually evolves into coalescent follicular depressions in a honeycombed or worm-eaten pattern may be present in ulerythema of the cheeks, also known as atrophoderma vermiculatum. From the cheeks, ulerythema may extend to the ears and forehead.

The condition usually improves as the patient ages, but a loss of the lateral aspects of the eyebrows is possible, and scars may develop in the affected areas.

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Complications

Scars may eventually develop at the sites of the hyperkeratotic papules.

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