P8.90 A CASE OF KERATOSIS PILARIS DECALVANS AND ACNE KELOIDALIS NUCHAE

Alvin H. Chong

Department of Dermatology, St Vincent’s Hospital Melbourne, Victoria, Australia

A 27 year old man with longstanding keratosis pilaris affecting his thighs and face presented with a 10 year history of a scarring alopecia affecting his vertex and a papular eruption on his neck. He has a family history of keratosis pilaris, but not of any scalp disorders. He had been treated with topical corticosteroids, intralesional steroids and oral minocycline with minimal improvement of his condition.

Clinically, there was a patch of inflammatory scarring alopecia on his vertex measuring 4cm across, with follicular crusting, pustules and tufted folliculitis. He also had a papular eruption on his neck consistent with acne keloidalis nuchae. On his face, he had fine erythematous papules consistent with keratosis pilaris affecting his cheeks and eyebrows, but no loss of eyebrow or eyelash hair. He also had follicular papules on his thighs. The inflammatory area on his vertex improved within weeks after being started on a 20 mg daily of isotretinoin.

Keratosis pilaris decalvans belongs to a heterogeneous group of disorders characterized by the presence of follicular keratoses and scarring alopecia. Acne keloidalis nuchae has not previously been described as a part of this disorder.