Abstract:

A 24-year-old man presented with a 6-year history of pustules, atrophic scars, and alopecia of the scalp. Dermatological examinations showed generalized alopecia and atrophic scarring of the scalp. A few hairs remained at the vertex region with keratotic papules, pustules, or black scars around the hair follicles. There were also residual hairs at the forehead, temples, and occipital region near the hairline. Clusters of hairs were noted in the occipital region, and keratotic papules were observed around the hair follicles. Erythema, scales, and follicular keratotic papules were found in the superciliary arch. The eyebrows and axillary hairs partially shed and were sparse. Follicular keratotic papules were also found on both cheeks, axillae, chest, abdomen, back and limbs. Stomatological examinations revealed a large space between the upper and lower anterior teeth, anteverted upper anterior teeth, congenital absence of ■ tooth, deep overbite and deep overjet of anterior teeth. He had a fissured tongue which lacked filiform papillae. Pathological examinations of the skin lesions showed a thickened spinous layer and massive infiltrations of plasmacytes, neutrophils, and multinucleated giant cells around hair follicles. A diagnosis of folliculitis spinulosa decalvans was made based on the clinical manifestations and histopathological findings.

Key words: folliculitis, decalvans, spinulosa