UO is a form of KPA affecting particularly and initially the eyebrow areas; in some cases extending later to the cheeks and forehead.11 Scalp and eyelash hair is normal. The onset is within months of birth, with erythema and small keratotic follicular papules involving the lateral one-third of the eyebrows. It may slowly progress through childhood to involve more of the eyebrows and sometimes beyond, leading to alopecia . Progression usually ceases after puberty but the sequelae are permanent. The condition is frequently associated with standard KP involving the arms and legs.
Most cases have followed an autosomal dominant inheritance pattern, with incomplete penetrance. Response to topical corticosteroids, topical retinoids, and keratolytics has been poor. There is one report of a good response to several months' therapy with oral isotretinoin, with lessening of the horny plugs and the erythema. The improvement was maintained for some months after therapy had ceased. Some improvement in erythema was reported with the pulsed tunable dye laser at 585 nm, but the follicular plugging was unchanged.