Erythromelanosis follicularis faciei et colli

Erythromelanosis follicularis faciei et colli is an erythematous pigmentary disease involving the follicles, characterized by a reddish-brown, sharply demarcated, symmetrical discoloration involving the preauricular and maxillary regions.

Signs and symptoms
Erythromelanosis follicularis faciei et colli is characterized by patches of erythema (with or without telangiectasia), follicular papules (follicular plugging), and bilateral and symmetrical hyperpigmentation (reddish-brown pigmentation) that start on the preauricular areas and cheeks and can eventually migrate to the submandibular portions of the neck.

Causes
Although the cause of this disorder is unknown, familial cases, spontaneous mutation, and an autosomal recessive pattern of inheritance have all been documented.

Diagnosis
Histopathologic observations include vascular dilatation in the upper dermis, hyperkeratosis, follicular plugging, and enhanced basal membrane pigmentation.

Treatment
Topical therapies include metronidazole, ammonium lactate, tacalcitol ointment, retinoids, hydroquinone, and salicylic acid. There have been reports of erythema and hyperpigmentation treated with pulsed dye laser or YAG laser.