Erythromelanosis follicularis of the face

 

Erythromelanosis follicularis of the face and neck has seldom been described in the literature. It is a condition of unknown aetiology. The clinical features are reddish-brown pigmentation, telangiectatic vessels, and pale follicular papules localized in the peri-auricular area. The disease is asymptomatic and has only been described in men.

Characteristically, it affects males in adolescence or young adulthood. It begins symmetrically on the preauricular cheeks and imperceptibly spreads onto the temples and lateral aspects of the neck. It presents an irregularly marginated, red-brown pigmentation with fine telangiectasia, small, pale, slightly scaly, follicular papules, and patchy alopecia of vellus hair.

The histologic features, although nondiagnostic, correlate well with the clinical features. The possible relationship to keratosis pilaris rouge is discussed.