Scarring Alopecia of Eyebrows with Comedonal Lesions in a Young Boy

A 12-year-old boy, known case of cryptorchidism, planned for orchidopexy, presented with comedonal lesions on the face [Figure 1a], predominantly involving cheeks, ear conchae, and temporal region. He also had erythematous keratotic papules on upper arms and complete loss of both eyebrows. Dermatoscopic evaluation of eyebrows confirmed the presence of scarring alopecia by loss of hair follicles and that of comedonal lesions revealed the presence of multiple discrete, homogenous, and blackish and few whitish keratotic comedonal plugs within dilated follicular openings [Figure 1b]. All relevant systemic workup was done to rule out a syndromic association (Noonan syndrome, Cornelia De Lange syndrome, Rubinstein Taybi syndrome, and cardiofaciocutaneous syndrome). This included a detailed investigative workup after neurological, cardiac, ophthalmological, audiological, renal, and genetic consultations. A diagnosis of ulerythema ophryogenes with comedonal lesions was established. The patient was started on oral isotretinoin 10 mg/day therapy. After receiving the therapy for 1 month, the patient showed significant improvement [Figure 2].Figure 1: (a) Multiple, discrete, black, comedonal lesions on the face, involving both cheeks with complete loss of both eyebrows; (b) Dermatoscopic evaluation revealed presence of multiple discrete, homogenous, blackish and few whitish keratotic comedonal plugs within dilated follicular openings (DermLite IV, ×10, polarized)Figure 2: Significant improvement after 1 month of oral isotretinoin therapyDeclaration of patient consent The authors certify that they have obtained all appropriate parent consent forms. In the form, the parent has given their consent for his images and other clinical information to be reported in the journal. The parent understands that his name and initials will not be published. Financial support and sponsorship Nil. Conflicts of interest There are no conflicts of interest.