Tufted-hair folliculitis

Abstract

A 21-year-old man presented with an erythematous pruritic plaque on the right parietal scalp of 2 years' evolution. Physical examination disclosed multiple bundles of hairs emerging from single dilated follicular openings. The disorder followed a relapsing and progressive course, in spite of several topical and systemic treatments. New tufts of hairs appeared in previously non-involved areas only after inflammatory changes occurred. The clinicopathological features, aetiological mechanisms and management of tufted-hair folliculitis are discussed. Tufted-hair folliculitis (THF) is a localized, inflammatory and exudative disease of the scalp characterized by a tufted appearance of the scalp hair, that may result in permanent and irreversible scarring alopecia. This condition was initially described by Smith and Sanderson in 1978 who coined the term THF to illustrate the phenomenon of multiple hairs emerging from single follicular openings. Only nine additional cases of THF have been reported elsewhere. We present herein a patient with recurrent and progressive THF resistant to several therapeutic strategies.