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

Updated: Jul 26, 2019
  • Author: Robert P Feinstein, MD; Chief Editor: Dirk M Elston, MD  more...
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Overview

Background

Favre-Racouchot syndrome is a disorder consisting of multiple open and closed comedones in the presence of actinically damaged skin. The disease was originally described in 1932 by Favre [1] and reviewed in detail by Favre and Racouchot in 1951. [2]

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Pathophysiology

This syndrome is limited to the skin. No internal manifestations occur.

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Etiology

Although the precise pathogenesis of the disorder is unknown, it develops in individuals with a heavy smoking history and chronic exposure to UV light. [3]  Vogel et al described a case of unilateral Favre-Racouchot syndrome indicating the etiologic role of chronic solar damage in this disease. [4]  Owing to the strong association with smoking, and the name "smokers’ comedones" has been proposed. [5] It may represent a manifestation of chloracne, although both ultraviolet and infrared light exposure may contribute.

The disorder also may follow exposure to radiation therapy. [6, 7] This was illustrated in a paper by Hoff et al, in which a 71-year-old man treated with radiation therapy for a malignant melanoma of the right paranasal sinus. He subsequently developed elastosis, open and closed comedones, and cysts in the radiation field. [8]

Lim et al, in a discussion of the adverse effects of UV radiation from the use of indoor tanning equipment, has cited Favre-Racouchot syndrome as one of these adverse effects. [9]

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Epidemiology

US frequency

In the United States and worldwide, this disorder has been reported to occur in 6% of adults older than 50 years.

Race

This disorder is found most commonly in whites, but isolated cases have been reported in dark-skinned people.

Sex

Males are affected much more commonly, but cases have been reported in women.

Age

Middle-aged to elderly individuals mostly are affected, although reports of young adults developing the problem exist.

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Prognosis

Prognosis is excellent, if properly treated. Favre-Racouchot syndrome is of cosmetic concern. It is an indication that the individual has had chronic excessive exposure to UV light. It is also strongly associated with heavy cigarette smoking. [3]

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Patient Education

Strongly advise the patient to avoid sun exposure and to use a sunblock daily, as continued UV damage will aggravate the disorder and potentiate the development of precancers and skin cancers.

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