Atrophoderma verruciformis: causes, symptoms, diagnosis, treatment

Atrophoderma vermiformis (syn.: vermiform acne, symmetrical reticular atrophoderma of the face, reticular cicatricial erythematous folliculitis, etc.). The etiology and pathogenesis are unknown. The presence of familial cases indicates a possible role of hereditary factors. Some authors point to the similarity of vermiform atrophoderma and erythema supraorbitalis. Clinically, there are closely spaced foci of atrophy, mostly follicular1, 1-3 mm in size and about 1 mm deep, separated by narrow strips of unchanged skin, which gives the foci a reticular character reminiscent of a honeycomb. There may be a few comedones, whiteheads, follicular plugs surrounded by erythema, mainly at the onset of the disease. Pigmentation is sometimes observed. The foci are located in the cheek area, usually symmetrically. Cases of unilateral or widespread location of lesions have been described. The disease begins in childhood, less often in adolescence, the course is chronic with slow progression and stabilization of the process by the period of puberty. Association with other congenital anomalies and hereditary diseases is possible: Marfan syndrome, neurofibromatosis, congenital heart defects, mental retardation.

Pathomorphology. There is follicular hyperkeratosis, atrophic changes in the epidermis and hair follicles with the formation of small horny cysts. In the dermis, there are limited perifollicular and perivascular infiltrates of a mononuclear nature, focal rarefaction of elastic fibers, dilation of capillaries, especially around the follicles and in the subepidermal areas.

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