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A Case of Folliculitis Decalvans With Concomitant Acne Keloidalis Nuchae, Androgenic Alopecia, and Profound Postinflammatory Hyperpigmentation

Gleed, Mitchell; Carlson, Kim

Journal of the Dermatology Nurses' Association: April 24, 2019 - Volume Publish Ahead of Print - Issue - p
doi: 10.1097/JDN.0000000000000467

ABSTRACT Folliculitis decalvans is a cicatricial alopecia of the parietal scalp and vertex characterized by erythematous, scarred, confluent patches of alopecia with scattered peripheral pustules and scale. It is most common among middle-aged men and is frequently associated with acne keloidalis nuchae. The pathogenesis of folliculitis decalvans is not completely understood, but it likely involves an inappropriate inflammatory response to components of Staphylococcus aureus. Folliculitis decalvans is a chronic disease characterized by periods of remission and exacerbation. Patients with long-standing, undertreated disease can experience severe hair loss and postinflammatory hyperpigmentation. Treatment is focused on reducing inflammation and bacterial load using oral antibiotic therapy. Early recognition and treatment is paramount to alleviate symptoms and limit irreversible hair loss.

Mitchell Gleed, BS, Arizona College of Osteopathic Medicine, Midwestern University, Glendale, AZ.

Kim Carlson, RN, MSN, NP-C, DCNP, MacKenzie Dermatology, Prescott, AZ.

The authors declare no conflict of interest.

Correspondence concerning this article should be addressed to Mitchell Gleed, BS, 1304 S. 105th Pl. Apt. 1015, Mesa, AZ 85209. E-mail:

Copyright © 2019 by the Dermatology Nurses' Association.