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Disseminated Granulomatous Perifollicular Dermatosis With Comedones: A Follicular Variant of Lichen Nitidus or a New Entity?

Deza, Gustavo, MD*; Gallardo, Fernando, MD, PhD*; Barranco, Carlos, MD; Marquès, Laura, MD; Pujol, Ramon M., MD, PhD*

The American Journal of Dermatopathology: September 2018 - Volume 40 - Issue 9 - p 694–698
doi: 10.1097/DAD.0000000000001165
Extraordinary Case Report

Abstract: The presence of acquired generalized keratotic follicular papules and comedones developing in adulthood constitute an uncommon clinical situation. Although this clinical presentation has been described in several noninflammatory, inflammatory, and neoplastic skin disorders, its association with an exclusive perifollicular epitheliod or granulomatous inflammatory reaction represents an exceedingly rare phenomenon. We report a case of a 57-year-old male patient presenting clinically numerous acquired disseminated follicular papules and comedones, showing isolated perifollicular sarcoid-like granulomatous inflammatory infiltrates at the histological examination. These lesions experienced a complete spontaneous resolution after several months. The possibility that this disseminated, epithelioid, granulomatous, perifollicular dermatosis may represent an isolated follicular variant of lichen nitidus or a previously nonreported skin disorder is discussed.

*Department of Dermatology, Hospital del Mar- Institut Mar d'Investigacions Mèdiques, Universitat Autònoma de Barcelona (UAB), Barcelona, Spain;

Department of Pathology, Hospital del Mar- Institut Mar d'Investigacions Mèdiques, Barcelona, Spain; and

Department of Dermatology, Hospital de Santa Caterina, Girona, Spain.

Correspondence: Gustavo Deza, MD, Department of Dermatology, Hospital del Mar- Institut Mar d'Investigacions Mèdiques, Universitat Autònoma de Barcelona (UAB), Passeig Marítim, 25-29, 08003 Barcelona, Spain (e-mail: gustavo.deza@gmail.com).

The authors declare no conflicts of interest.

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