What are the other Names for this Condition? (Also known as/Synonyms)

• Acanthoma Fissuratum Cutis (AFC)
• Eyeglass Frame Acanthoma
• Spectacle Frame Acanthoma

What is Acanthoma Fissuratum? (Definition/Background Information)

• Acanthoma Fissuratum is a skin condition that manifests as papules or nodules at the site of continuous and persistent irritation caused by wearing eyeglasses/spectacles, typically behind the ears or on the bridge of the nose
• The skin lesions in Acanthoma Fissuratum are observed where the frames or nasal pads of the spectacle rest. Thus, the condition is also known as Spectacle Frame Granuloma
• Acanthoma Fissuratum is known to heal spontaneously, if wearing the eyeglasses are stopped for some period of time. Sometimes, an eyeglass technician must adjust the fit of the glasses, or change out the type of nasal pad

Who gets Acanthoma Fissuratum? (Age and Sex Distribution)

• Acanthoma Fissuratum may be observed in both children and adults
• Both males and females are affected
• Worldwide, there is no racial or ethnic preference observed

What are the Risk Factors for Acanthoma Fissuratum? (Predisposing Factors)

The risk factors for Acanthoma Fissuratum include:

• Wearing tight, heavy, or ill-fitting eyeglasses
• Wearing poor quality spectacles including those with frames having rough surfaces due to scratches or abrasion
• Presence of pre-existent skin conditions at the site of constant irritation of the frames
• Some individuals are more at risk due to certain anatomical features such as prominent ears

It is important to note that having a risk factor does not mean that one will get the condition. A risk factor increases one’s chances of getting a condition compared to an individual without the risk factors. Some risk factors are more important than others.

Also, not having a risk factor does not mean that an individual will not get the condition. It is always important to discuss the effect of risk factors with your healthcare provider.

What are the Causes of Acanthoma Fissuratum? (Etiology)

Acanthoma Fissuratum is caused from the constant pressing and rubbing of the eyeglass frames on skin (of the ears or nose). This causes friction and irritation at the skin site resulting in the formation of the lesions.

What are the Signs and Symptoms of Acanthoma Fissuratum?

The signs and symptoms of Acanthoma Fissuratum may include:

• Presence of skin lesions that are in the form of papules, nodules, or plaques
• Most of them are observed at the point of contact of the nasal pads or spectacle frame with the skin, such as on the nose bridge or just behind the external ear structure
• The lesions are usually firm and flesh-colored
• Pain and burning sensation are often noted
• In some individuals, the lesions are divided into two halves on either side of the spectacle frame (called coffee bean appearance)
• Ulceration or thickening of skin may be observed

How is Acanthoma Fissuratum Diagnosed?

A diagnosis of Acanthoma Fissuratum may involve the following exams and procedures:

• Physical examination of the individual and medical history evaluation (a history of wearing eyeglasses is important in establishing the diagnosis)
• Dermoscopy: Dermoscopy is a diagnostic tool where a dermatologist examines the skin using a special magnified lens
• Wood’s lamp examination: In this procedure, the healthcare provider examines the skin using ultraviolet light. It is performed to examine the change in skin pigmentation
• Skin biopsy: A skin tissue biopsy is performed and sent to a laboratory for a pathological examination. The pathologist examines the biopsy under a microscope. After putting together clinical findings, special studies on tissues (if needed) and with microscope findings, the pathologist arrives at a definitive diagnosis
• A differential diagnosis may be considered to eliminate conditions presenting similar signs and symptoms such as basal cell carcinoma

A skin tissue biopsy is not needed, although the dermatologist may request a biopsy based on his/her clinical assessment.

Many clinical conditions may have similar signs and symptoms. Your healthcare provider may perform additional tests to rule out other clinical conditions to arrive at a definitive diagnosis.

What are the possible Complications of Acanthoma Fissuratum?

The possible complications due to Acanthoma Fissuratum include:

• Difficulty in wearing eyeglasses
• Emotional stress due to cosmetic issues
• Superimposed bacterial and fungal skin infections
• Recurrence of the condition following treatment
• Permanent scarring

How is Acanthoma Fissuratum Treated?

The treatment measures available for Acanthoma Fissuratum may include:

• Stoppage of wearing eyeglasses for a period of time, until the skin lesions heal
• Topical applications are not generally needed
• The healthcare provider may recommend intralesional corticosteroid injections for severe cases that present intense pain and discomfort

How can Acanthoma Fissuratum be Prevented?

• Acanthoma Fissuratum may be prevented by using comfortable, well-fitting, and light glasses
• One may also consider switching to contact lens for a period of time, where possible, so that the skin lesions may heal

What is the Prognosis of Acanthoma Fissuratum? (Outcomes/Resolutions)

The prognosis of Acanthoma Fissuratum is generally good with adequate treatment, including wearing good fitting eyeglasses. However, the condition may recur if the spectacles become old and ill-fitting.

Additional and Relevant Useful Information for Acanthoma Fissuratum:

The following DoveMed website link is a useful resource for additional information:

https://www.dovemed.com/healthy-living/skin-disorders/