What Is Keratosis Pilaris Rubra?

Atrophic hair keratosis is a group of hereditary defects that are characterized by the formation of local atrophic changes after hair keratosis. The disease includes three types: facial atrophic perikeratosis, worm-like skin atrophy, and alopecia spinous follicle keratosis. Can also overlap between 3 types.

Basic Information

English name

keratosis pilaris atrophicans

Visiting department

dermatology

Multiple groups

Young men

Common locations

Facial

Common causes

Autosomal dominant inheritance may be related to abnormalities in hair follicles, sebaceous glands, and peripheral keratinization due to birth defects

Common symptoms

Persistent reticular erythema of the eyebrows and small keratinous follicular pimples, the center of the pimples has thin and easily broken eyebrows, and follicular papule before the ears, etc.

Causes of atrophic hair keratosis

Facial atrophic keratosis is autosomal dominant. The cause of worm-eaten skin atrophy is unknown. It may be related to congenital defects that cause abnormal hair follicles, sebaceous glands, and peripheral keratinization. It is a congenital hair follicle disease. Alopecia spinous follicular keratosis may be sex-linked negative.

Clinical manifestations of atrophic keratosis

1. Facial atrophic keratosis

It is a special type of facial hair moss. Its onset may be excessive keratinization of the upper third of the hair follicles, and hair growth is hindered outward, thus causing a secondary inflammatory reaction. Divided into two types.

(1) Scarred erythema of the eyebrow The skin lesion is characterized by persistent reticular erythema and small keratinous hair follicle papules. The center of the pimples has thin and easily broken eyebrows passing through, leaving a slight depression and atrophic scar after subsidence and permanent Sexual frown or alopecia areata. Occurs on the eyebrow, especially on the outside of the eyebrow arch, which can extend to the ear, forehead and even the scalp.

(2) Atrophic red hair keratosis is more common in young men. The skin lesions are follicular papules, surrounded by red halo around the ears, which can spread to adjacent skin, leaving pigmentation or reticulation after healing. .

2. Worm-like skin atrophy

Onset often in childhood. The lesions all originated from the bilateral condyles. The hair follicle papules were the size of a needle tip at first, and keratin plugs gradually appeared on the top of the pimples. After the horn plugs fell off, round or irregular concave skin with a diameter of 1 to 3 mm remained. Color atrophy spots and become typical damage, that is, most dense worm-like atrophy type pits. The disease can be associated with congenital heart disease, neurofibromatosis, mental retardation, or Down syndrome.

3. Alopecia spinous follicular keratosis, also known as follicular ichthyosis, Siemens syndrome

The keratosis of the hair of the disease begins with the appearance of numerous miliaria, keratinous horn plugs on the nose and cheeks, and later progresses the skin lesions involving the trunk and limbs, with palmar plantar keratosis, hair loss and scarring. Scarring hair loss on the scalp and eyebrows is a hallmark of the disease. Photophobia and corneal abnormalities are common complications, and can also be combined with deafness, physical and mental retardation, recurrent infections, nail malnutrition, and amino aciduria.

Diagnosis of atrophic keratosis

According to the patient's secondary atrophic changes after keratosis of the hair follicle, the possibility of this disease should be considered.

Differential diagnosis of atrophic keratosis

The disease needs to be differentiated from scar acne and scar after smallpox.

Atrophic keratosis treatment

There is no special treatment for this disease. Vitamin A and vitamin E can be taken orally during the period of hair follicle horn plug skin lesions, and 0.05% to 0.1% of vitamin A acid cream, 20% urea cream, or other keratolytic agents can be applied topically. All help to remove the corner plugs and reduce the occurrence of atrophic spots. For atrophic skin lesions, grinding or surgical skin grafting is given if necessary. Topical glucocorticoids can reduce the symptoms of erythema, exudation and inflammation. Hair loss on the head can be given to a hair transplant.

Prevention of atrophic hair keratosis

Health education for patients and their family members to avoid close relatives getting married. For skin lesions, do not use strong alkaline soaps or irritating drugs to prevent the skin from becoming too dry.