Trichostasis Spinulosa Confirmed by Standard Skin Surface Biopsy
A 25-year-old female patient was admitted with a complaint of black spots on her face. Lesions were present since the age of 13 years, and with a diagnosis of acne, she had used topical antibiotics (clindamycin and tetracycline) without any improvement. Dermatological examination revealed multiple black-colored macules located bilaterally on the cheeks and nose []. Dermoscopic examination revealed that the black macules were actually vellus hair. To examine these hairs, a standard skin surface biopsy (SSSB) was performed. Multiple vellus hair bundles in funnel-shaped structures were observed under the microscope [], and a diagnosis of ‘TS’ was made. A topically applied treatment, composed of 0.025% tretinoin and 4% erythromycin gel, was recommended daily at bedtime. Six weeks later, the appearance of black macular lesions on the face was significantly reduced. However, due to her pregnancy, the treatment had to be terminated, and her lesions recurred within 1 month.