Childhood flexural comedones: a new entity

Comedones are usually found in acne and involve the seborrheic areas of the skin. Disseminated comedones can be found in other skin disorders. Flexural comedones are characterized by double orifices connected by a thin layer of epidermis that reveals the comedo content below it. To the best of our knowledge, flexural comedones have not been previously described as an entity. Our objective was to characterize this disorder.

A cross-sectional descriptive study was performed from April 2004 to July 2006. We included 40 pediatric and adolescent patients with flexural comedones; 21 were female (52%), and 19 were male (48%) (mean age, 6.2 years). In 29 cases the lesions were single (72%) and in 32 cases (80%) unilateral. The lesions were located in the axilla in 88% of the patients. We performed biopsies of skin samples in 6 cases.

To our knowledge, flexural comedones have not been previously described as an entity, and we felt that they deserved attention owing to the relative frequency of cases in our clinical practice. Because of its clinical appearance, flexural localization, and age distribution, we named this disorder childhood flexural comedones. Further investigation and follow-up of a larger number of patients is needed.