Trichostasis spinulosa (TS) is a moderately common but rarely identified disorder of hair follicle characterized by dark, spiny hyperkeratotic follicular papules which commonly locally distribute on the face or extremities. Both women and men are affected equally and it can occur at any age after adolescence

A case report describes a 25-year-old female, who presented with a complaint of black spots on her face. She rendered the history of the presence of the lesions since the age of 13 years, and with a diagnosis of acne.

Multiple black-coloured macules located bilaterally on the cheeks and nose were observed on Dermatological examination while Dermoscopic examination revealed the black macules to be vellus hair. Further, a standard skin surface biopsy (SSSB) was performed to examine these hairs. Histopathological study revealed multiple vellus hair bundles in funnel-shaped structures, thus a diagnosis of ‘TS’ was made. 

She was initiated topical treatment with tretinoin 0.05% recommended daily at bedtime. The appearance of black macular lesions on the face significantly reduced after six weeks. 

TS may be unrecognized, and most of the cases are revealed parenthetically in patients who visit a hospital with other skin conditions.

Gündüz O, Aytekin A. Trichostasis spinulosa confirmed by standard skin surface biopsy. Int J Trichology. 2012;4(4):273-274. doi:10.4103/0974-7753.111201