![]() In addition, 13 of our patients had associated molluscum contagiosum. Because comedones are clinically and histopathologically precursor lesions of HS, 7, 8 we hypothesize that childhood flexural comedones are related to HS. The chronic disease HS is characterized by painful suppurative or inflammatory lesions in the axilla or genitofemoral region. Because of the typical clinical appearance, flexural localization, and age distribution, we refer to this disorder with the descriptive term childhood flexural comedones. We felt that they deserved attention owing to the relative frequency of cases in our clinical practice. To our knowledge, flexural comedones have not been previously described as an entity. Remarkable associated features were inflammatory acne in 2 cases, comedonal acne in 1 case, and ovarian cysts with an axillary infundibular cyst in 1 patient. Four cases were familial.įindings from skin biopsy samples from 6 cases showed the typical open comedo picture, with follicular plugging and infundibular dilatation. In 1 case we found both axillary and groin lesions. The other affected sites were much less frequent. The most common site was the axilla (35 ). Of the 11 patients presenting multiple lesions, 8 were bilateral and 3 unilateral. The lesions were single in 72% of cases and unilateral in 80% of them. In 25 cases the patient's age at onset of the disease was unknown it is remarkable that in 1 case the lesion was congenital. Although flexural comedones were the main concern in 9 patients (22%), in most of the cases they were an incidental finding during dermatologic examination for other conditions. There was no sex preponderance in our series of cases. ![]() One patient had a personal history of ovarian cysts associated with an infundibular cyst on the axilla, and 1 had juvenile rheumatoid arthritis. ![]() Flexural comedones represented the main complaint in 9 cases (22%), whereas in the other cases (26 ), 13 patients or their parents had concerns regarding molluscum contagiosum 5 had concerns regarding atopic dermatitis 2, inflammatory acne 1, comedonal acne and milium cysts 1, eruptive milia 1, morphea 1, vitiligo 1, scabies and 1, keratosis pilaris. Among the 40 patients, the lesions were most commonly located in the axilla in 35 (88%), the groin in 3 (8%), the antecubital fossa in 2 (5%), and the neck in 1 (2%). Flexural comedones were unilateral in 32 cases (80%) and bilateral in 8 (20%). In 29 cases the lesions were single (72%) ( Figure 1 and Figure 2), whereas in 11 they were multiple (28%) 8 were bilateral and 3 unilateral ( Figure 3). In the remaining 15 (38%), the mean period of time between the patient- or parent-reported onset of the lesions and the diagnosis was 18.1 months (range, 1-84 months). The age at onset of the lesions was unknown in 25 patients (62%). We observed 40 patients with flexural comedones 21 were female (52%) and 19 were male (48%) the mean age was 6.2 years (range, 2-15 years). The study was performed in Ramos Mejía Hospital, Buenos Aires, Argentina, and in a private dermatology practice. All of them had double-orifice comedones located on flexural areas. We included pediatric and adolescent patients ranging in age from birth to 16 years. Further investigation and follow-up of a larger number of patients is needed.Ī cross-sectional descriptive study was performed from April 2004 to July 2006. Because of its clinical appearance, flexural localization, and age distribution, we named this disorder childhood flexural comedones. ![]() We performed biopsies of skin samples in 6 cases.Ĭonclusions To our knowledge, flexural comedones have not been previously described as an entity, and we felt that they deserved attention owing to the relative frequency of cases in our clinical practice. The lesions were located in the axilla in 88% of the patients. In 29 cases the lesions were single (72%) and in 32 cases (80%) unilateral. We included 40 pediatric and adolescent patients with flexural comedones 21 were female (52%), and 19 were male (48%) (mean age, 6.2 years). Observations A cross-sectional descriptive study was performed from April 2004 to July 2006. Our objective was to characterize this disorder. To the best of our knowledge, flexural comedones have not been previously described as an entity. Flexural comedones are characterized by double orifices connected by a thin layer of epidermis that reveals the comedo content below it. Disseminated comedones can be found in other skin disorders. Shared Decision Making and Communicationīackground Comedones are usually found in acne and involve the seborrheic areas of the skin.Scientific Discovery and the Future of Medicine.Health Care Economics, Insurance, Payment.Clinical Implications of Basic Neuroscience.Challenges in Clinical Electrocardiography. ![]()
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