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Sebaceous Filaments

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Case Presentation

A 16-year-old boy with a known case of autism spectrum disorder presented with complaints of multiple yellowish white deposits over hair-bearing areas of his face for the previous 3 years. On examination, there were multiple filamentous, off-white to yellowish, follicular growths in his perioral region, eyelashes, eyebrows, nose, and cheeks ( Figure 1A ). Dermoscopy revealed uniform cylindrical, solid, off-white colored deposits encircling normal hair follicles ( Figure 1B ). The gram stain and potassium hydroxide preparations were negative. The growths were clinically diagnosed to be sebaceous filaments.

Figure 1 .

(A) Filamentous, off-white to yellowish follicular growths in the perioral region, eyelashes, eyebrows, nose, and cheeks. (B) Uniform, cylindrical, solid, off-white colored deposits encircling normal hair follicles seen on non-polarized dermoscopy.

Teaching Point

Sebaceous filaments are yellowish to off-white collections of sebum and dead cells around hair follicles. These are usually found in normal healthy individuals predominantly on the nose, and they mimic comedones and trichostasis spinulosa [ 1 ] . The tail of the Demodex mite is an important differential on dermoscopy. In our patient, neglect of personal hygiene and possible genetic predisposition resulted in considerable growth of these sebaceous filaments.

Reference

  1. Arch Dermatol Res Plewig G, Wolff HH. 1976.

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