By Gary M. White, MD

Necrotizing infundibular crystalline folliculitis (NICF) is a rare superficial acneiform deposition disease characterized by expansive deposits of crystallized lipid within a disrupted epidermis.


The rash appears as multiple follicular waxy papules with erythematous borders usually on the back of elderly men or on the face and neck of younger patients.

Histopathologic examination reveals disruption of the epidermis by urate-like crystalline deposits, often flanked by columns of parakeratin and embedded in a mucopolysaccharide matrix. It has been proposed that NICF is more common than widely recognized and use of a non-aqueous histologic technique may improve its recognition.


A 46-year-old woman presented with a 1-month history of flesh-colored 1-2 mm papules across the lateral face and neck. The patient reported intermittent acne throughout her life and was being treated with 50 mg oral doxycycline/day. Dermatology Online Journal 23(7)


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