Atrophoderma vermiculata usually begins in childhood with the onset is between 5 and 12 years old. The cheeks are predominantly involved, with follicular plugs and pit-like depressions and a background of erythema. The depressions merge into each other lead to a striking honeycomb-like atrophy. Scarring alopecia may occur, but rarely. The course is usually one of inexorable worsening. The condition is often sporadic but, in some cases, appears to be inherited as an autosomal dominant trait.