A Case Report of Sebaceous Filaments

This report details a case of a 16-year-old African American girl who presented with a two-year history of white spicules on her face without associated symptoms, including pruritus or pain. On physical examination, there were many 1-2 mm discreet white to yellow filamentous spicules on the mid and lower face. Histopathology scrapings showed cornified cells and calcification consistent with sebaceous filaments. Sebaceous filaments are a rare condition that presents as white-to-yellow spicules distributed in highly sebaceous areas on the face. It is caused by sebum accumulation and cornified keratinocytes surrounding hair follicles, resulting in visible excretions. Treatment of sebaceous filaments is targeted at reducing the size of sebaceous glands which subsequently decreases excretions and improves skin appearance. Despite low incidence, sebaceous filaments are likely under-reported. It is important for dermatologists to recognize and treat sebaceous filaments in patients who present with this condition to improve their appearance and quality of life. The present patient was successfully treated with topical tretinoin.