P#53  A case of tufted folliculitis

Park Min Su, Shur Ki-Beom, Lee Jeung Hoon and Park Jang-Kyu. Dept of Dermatology, Chungnam National University - School of Medicine, Taejon, Korea

Tufted folliculitis is an uncommon folliculitis of the scalp that resolves with patches of scarring alopecia within which multiple hair tufts emerge from dilated follicular orifices. 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. The initial pathologic finding was inflammation and scarring of the papillary and mid dermis with almost total sparing of the hair follicles in the subcutaneous fat. Each tuft comprised 10 to 15 normal-appearing hairs arising from individual hair follicles in the reticular dermis or subcutaneous fat, converging toward a single orifice in the epidermis.

A 29-year-old woman presented with 2 month history of erythematous nodule and oozing on vertex of scalp. Erythema, follicular hyperkeratosis and multiple tufts of 10-20 hairs arising out of dilated hair follicles. Histologic examination showed acanthosis and perifollicular inflammatory infiltration composed of lymphocyte, histiocyte and plasma cell. These physical and histologic features were consistent with a diagnosis of tufted folliculitis. Treatment is not so effective and someone report that surgical excision or topical nadifloxacin were effective. In our case, topical and intralesional steroid application was applied but no response achieved.