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Year : 2014  |  Volume : 5  |  Issue : 6  |  Page : 132-133  

Trichostasis spinulosa: An overlooked entity

Department of Dermatology, Sri Dharmasthala Manjunatheshwara College of Medical Sciences and Hospital, Sattur, Dharwad, Karnataka, India

Date of Web Publication5-Dec-2014

Correspondence Address:
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
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Source of Support: None, Conflict of Interest: None

DOI: 10.4103/2229-5178.146195

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How to cite this article:
Naveen KN, Shetty SR. Trichostasis spinulosa: An overlooked entity. Indian Dermatol Online J 2014;5, Suppl S2:132-3

How to cite this URL:
Naveen KN, Shetty SR. Trichostasis spinulosa: An overlooked entity. Indian Dermatol Online J [serial online] 2014 [cited 2022 Jan 26];5, Suppl S2:132-3. Available from: https://www.idoj.in/text.asp?2014/5/6/132/146195

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 1: Multiple black macules on nose

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Figure 2: Dermoscopic (×25 and ×60) examination revealing vellus hairs

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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. [1],[2]

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." [1] 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. [1],[2]

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. [1],[2]

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. [3] 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. [1] Repeated peeling with capryloyl salicylic acid has given good result. [2]

Herein we present a classical case of TS to increase the awareness of this common disease.

   References Top

Gutte RM. Itchy black hair bristles on back. Int J Trichology 2012;4:285-6.  Back to cited text no. 1
Wollina U. Trichostasis spinulosa-successful treatment by repeated peeling with capryloyl salicylic acid. J Clin Exp Dermatol Res 2012;3:2.  Back to cited text no. 2
Strobos MA, Jonkman MF. Trichostasis spinulosa: Itchy follicular papules in young adults. Int J Dermatol 2002;41:643-6.  Back to cited text no. 3


  [Figure 1], [Figure 2], [Figure 3]

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