Background
Favre-Racouchot syndrome is a disorder consisting of multiple open and closed comedones in the presence of actinically damaged skin. The disease was originally described in 1932 by Favre [1] and reviewed in detail by Favre and Racouchot in 1951. [2]
Pathophysiology
This syndrome is limited to the skin. No internal manifestations occur.
Etiology
Although the precise pathogenesis of the disorder is unknown, it develops in individuals with a heavy smoking history and chronic exposure to UV light. [3] Vogel et al described a case of unilateral Favre-Racouchot syndrome indicating the etiologic role of chronic solar damage in this disease. [4] Owing to the strong association with smoking, and the name "smokers’ comedones" has been proposed. [5] It may represent a manifestation of chloracne, although both ultraviolet and infrared light exposure may contribute.
The disorder also may follow exposure to radiation therapy. [6, 7] This was illustrated in a paper by Hoff et al, in which a 71-year-old man treated with radiation therapy for a malignant melanoma of the right paranasal sinus. He subsequently developed elastosis, open and closed comedones, and cysts in the radiation field. [8]
Lim et al, in a discussion of the adverse effects of UV radiation from the use of indoor tanning equipment, has cited Favre-Racouchot syndrome as one of these adverse effects. [9]
Epidemiology
US frequency
In the United States and worldwide, this disorder has been reported to occur in 6% of adults older than 50 years.
Race
This disorder is found most commonly in whites, but isolated cases have been reported in dark-skinned people.
Sex
Males are affected much more commonly, but cases have been reported in women.
Age
Middle-aged to elderly individuals mostly are affected, although reports of young adults developing the problem exist.
Prognosis
Prognosis is excellent, if properly treated. Favre-Racouchot syndrome is of cosmetic concern. It is an indication that the individual has had chronic excessive exposure to UV light. It is also strongly associated with heavy cigarette smoking. [3]
Patient Education
Strongly advise the patient to avoid sun exposure and to use a sunblock daily, as continued UV damage will aggravate the disorder and potentiate the development of precancers and skin cancers.
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Multiple comedones, dilated and plugged follicular infundibula, and epidermal cyst formation. Courtesy of DermNet New Zealand and Pathlab Bay of Plenty (https://www.dermnetnz.org/assets/Uploads/pathology/t/figure2favrerac.jpg).
