P28 Traumatic anserine folliculosis: a cause of facial follicular papules

Abstract

Abstract Traumatic anserine folliculosis (TAF) is an infrequently reported condition, presenting with grouped follicular papules, usually on the face of young people, induced by repeated frictional trauma or pressure. A suggestive history may allow clinical differentiation of TAF from other folliculocentric keratotic disorders. We present three children diagnosed with TAF in our department: (i) A 12-year-old boy with asymmetry of the mental protuberance, presented with a 1-year history of scaly, lichenified erythema with monomorphic nonpigmented papules over the more prominent side; histology showed mild hyperkeratosis and some rudimentary hair follicles with keratin-filled follicular openings. (ii) A 7-year-old boy with a 1-year history of a hyperpigmented patch on the chin with multiple skin-coloured papules and a sandpaper feel; dermoscopy showed follicular papules with keratin plug; he had a habit of reading with his chin resting on his knee; the skin changes improved with topical retinoid and postural changes. (iii) A boy with follicular papules on one cheek since the age of 8 years, with history of persistent leaning his hand on his cheek while reading; the papules resolved with a change in posture, but similar changes arose at a new pressure area on his chin. The clinical features of grouped monomorphic skin-coloured follicular papules on an erythematous or hyperpigmented background, and a suggestive history, may allow the diagnosis of TAF. Described histological findings are hyperkeratosis, rudimentary follicles and dilated follicular openings filled with keratotic material. Management includes identifying and correcting postural habits; topical keratolytic agents and retinoids may also be beneficial.