Generalized Asymptomatic Cutaneous Pits and Comedones in a Young Woman

May 2024 in “ Indian Journal of Dermatology ”

Keshavmurthy A Adya, Aparna Palit

cutaneous pits comedones follicular Dowling-Degos disease hair follicles retinoids laser resurfacing melanization skin pits blackheads DDD laser treatment skin pigmentation

TLDR The woman has a rare skin condition called follicular Dowling-Degos disease, which has limited treatment options.

A 22-year-old woman presented with multiple asymptomatic, progressive dark papular and pitted skin lesions over the past 5 years, with a similar history in her father. Examination and biopsy confirmed a diagnosis of follicular Dowling-Degos disease (DDD), a rare variant of the classical form of the disease, characterized by lesions confined to hair follicles. Histology showed features similar to classical DDD but limited to the follicular infundibular epithelium. The patient was informed about the disease and the lack of curative treatment, and was offered fractional carbon dioxide laser resurfacing for cosmetic improvement, but was lost to follow-up. This case highlights the importance of recognizing follicular DDD for appropriate diagnosis and management.

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