This is a skin change occurring mostly in elderly subjects that superficially shows some resemblance to open comedones. The black follicular plugs, especially common on the nose and cheeks, remind one automatically of blackheads. The pore of almost every sebaceous follicle is distended by a slightly pigmented, yellowish-brown to black elevated plug. No inflammation stems from these lesions. The matter is firmly rooted and cannot be easily delivered by pressure. The lesions always remain small and do not attain the size of true open comedones. Most of the patients are older, far beyond the acne age, though trichostasis spinulosa can occur after puberty and in early adulthood when acne vulgaris is still active. Therefore, this is an important differential diagnosis.
KeywordsAcne Extractor Tretinoin Cyanoacrylate Rosacea
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