Favre-Racouchot Nodular Elastosis

A 69-year-old woman, who was being seen regularly for treatment of psoriasis, was noted to have numerous open comedones on the sides of her face in association with photodamaged skin.

This is Favre-Racouchot nodular elastosis (or nodular elastoidosis with cysts and comedones), a condition classified in the group known as the solar elastotic syndromes; they are characterized microscopically by the accumulation of degenerative material that stains with elastic tissue stains.

Favre-Racouchot syndrome, which is more prevalent in men, typically affects the periorbital and malar skin but may also occur at other sites of photodamage, such as the nose, neck, and retroauricular area. Initially, enlarged pilosebaceous orifices filled with keratinous debris appear on a background of photodamaged skin.

n some advanced cases, cystic nodules develop that may coalesce into thickened, yellowish plaques containing large comedones. The condition is thought to result from weakening of the supporting stroma surrounding pilosebaceous units secondary to photodamage.