|THROUGH THE LENS
|Year : 2014 | Volume
| Issue : 6 | Page : 132-133
Trichostasis spinulosa: An overlooked entity
Kikkeri Narayanasetty Naveen, Suraj R Shetty
Department of Dermatology, Sri Dharmasthala Manjunatheshwara College of Medical Sciences and Hospital, Sattur, Dharwad, Karnataka, India
|Date of Web Publication||5-Dec-2014|
Dr. Kikkeri Narayanasetty Naveen
Department of Dermatology, No 10, Skin OPD, Sri Dharmasthala Manjunatheshwara College of Medical Sciences and Hospital, Sattur, Dharwad - 580 009, Karnataka
Source of Support: None, Conflict of Interest: None
|How to cite this article:|
Naveen KN, Shetty SR. Trichostasis spinulosa: An overlooked entity. Indian Dermatol Online J 2014;5, Suppl S2:132-3
A 50-year-old female visited our department for the treatment of rosacea. Dermatological examination revealed erythematous papules and plaques over both cheeks. Black macules were found on the nose [Figure 1], but the patient was not worried about the lesions. Dermoscopic (×25 and ×60) examination revealed that the black macules were vellus hairs [Figure 2]. The hairs were plucked and observed under dermascope which showed multiple vellus hairs bundled in a funnel-like structure [Figure 3]. The above findings were suggestive of trichostasis spinulosa (TS). Patient refused treatment for the lesions.
|Figure 3: Plucked hairs observed under dermascope (×25 and ×60) showing multiple vellus hairs bundled in a funnel-like structure|
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TS is a very common but unrecognized disorder of pilosebaceous unit. It is a midfacial disease that occurs in younger age in female patients with Fitzpatrick skin type III or higher. It may also occur in light-skinned older people with excessive ultraviolet-exposure. ,
TS was first recognized by the German dermatologist Felix Franke in 1901, who named it "Pinselhaar" (paintbrush hair). In 1913, Noble first coined the term "trichostasis spinulosa."  The exact etiology of this disease is not known. Abnormal angulation of the hair follicle may lead to the entrapment of vellus hairs. Follicular hyperkeratosis of a dilated vellus hair follicle leading to retention of successive telogen hairs is another explanation. Number of retained hairs may range from 5 to 60. ,
TS occurs sporadically, but many trigger factors have been identified. These include topical minoxidal, topical steroids, chronic renal failure, dust, oils, ultraviolet light, heat, and irritants. ,
Two variants of TS have been described: Nonpruritic type, which is classical and often seen in the elderly as asymptomatic blackhead-like lesions located on the face. The other variant is the pruritic type, characterized by multiple pinhead-sized papules on the trunk and upper extremities in young adults.  The present case is a classical type with the involvement of nose.
Various modalities of treatment are tried with variable results which includes emollients, hydroactive adhesive tapes, local keratolytics, local and oral retinoids.  Repeated peeling with capryloyl salicylic acid has given good result. 
Herein we present a classical case of TS to increase the awareness of this common disease.
| References|| |
Gutte RM. Itchy black hair bristles on back. Int J Trichology 2012;4:285-6.
Wollina U. Trichostasis spinulosa-successful treatment by repeated peeling with capryloyl salicylic acid. J Clin Exp Dermatol Res 2012;3:2.
Strobos MA, Jonkman MF. Trichostasis spinulosa: Itchy follicular papules in young adults. Int J Dermatol 2002;41:643-6.
[Figure 1], [Figure 2], [Figure 3]