History
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.
Physical Examination
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. [10]
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. [11]
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Multiple comedones, dilated and plugged follicular infundibula, and epidermal cyst formation. Courtesy of DermNet New Zealand and Pathlab Bay of Plenty (https://www.dermnetnz.org/assets/Uploads/pathology/t/figure2favrerac.jpg).
