North Texas Research Forum 2024



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North Texas


Medical City Fort Worth



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favre-racouchot syndrome, facial dermatoses, radiation therapy


Dermatology | Medicine and Health Sciences | Neoplasms | Skin and Connective Tissue Diseases | Therapeutics


Introduction: Favre-Racouchot Syndrome is a cutaneous disease characterized by nodules, cysts, and comedones located in sun-exposed areas of the face. It is most commonly found on the bilateral temporal and periorbital skin. Favre-Racouchot Syndrome is most associated with chronic sun exposure. It occurs more commonly in cigarette smokers. It has been rarely associated with radiation therapy. It has not been reported after image-guided superficial radiation therapy or in a geometric pattern. Case presentation: We present the first two recorded cases of Favre-Racouchot Syndrome occurring in the setting of image-guided superficial radiation therapy. Both patients presented with well-demarcated geometric plaques with large open comedones isolated to the treatment field. One patient had a plaque on the forehead and the other on the midface. Both patients were current users of tobacco products during their radiation treatment. Both patients were initially treated with adapalene 0.1% gel nightly to the affected area. Shave removal followed by curettage was performed on the nasal lesion with the resolution of the majority of comedones. Histopathology of the removed lesions showed dilated follicular orifices filled with cornified debris forming comedones. Learning points: The combination of underlying chronic actinic damage, radiation, and tobacco use may increase the risk of developing Favre-Racouchot Syndrome. While patients are undergoing radiation treatments it may be beneficial to abstain from tobacco until treatments have been completed and the skin has healed. This may help to prevent Favre-Racouchot Syndrome in the setting of radiation treatments. Favre-Racouchot Syndrome is easily recognized by its geometric pattern. The differential diagnosis includes skin cancer recurrence. Image-guided superficial radiation therapy is becoming a more common treatment for non-melanoma skin cancers. Patients are concerned these skin changes represent a recurrence of their skin cancer. It is important for clinicians treating persons with non-melanoma skin cancer to be aware of this complication. This will allow patient reassurance and reduce biopsies. Geometric Favre-Racouchot Syndrome can be treated with curettage.

Original Publisher

HCA Healthcare Graduate Medical Education

Geometric Favre-Racouchot Syndrome Following Image-Guided Superficial Radiation Therapy



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