Folliculitis decalvans: the use of dermatoscopy as an auxiliary tool in clinical diagnosis

Abstract

Folliculitis decalvans is an inflammatory presentation of cicatrizing alopecia characterized by inflammatory perifollicular papules and pustules. It generally occurs in adult males, predominantly involving the vertex and occipital areas of the scalp. The use of dermatoscopy in hair and scalp diseases improves diagnostic accuracy. Some trichoscopic findings, such as follicular tufts, perifollicular erythema, crusts and pustules, can be observed in folliculitis decalvans. More research on the pathogenesis and treatment options of this disfiguring disease is required for improving patient management.

Clinical, Histological and Trichoscopic Correlations in Scalp Disorders

“…They are an expression of a compound of follicular structures and are seen in advanced cases, both clinically and by trichoscopy. Tufted hairs can be seen also in acne keloidalis, LPP and central centrifugal alopecia; however, in these conditions the tufts consist only of 2-3 hairs [25,26]. …”

Journal of Surgical Dermatology Volume 1 Issue 2: Full Issue

“…The laser spot is focused at a depth of 0.1-2.0 mm in the skin, and the specific amount of thermal build-up determines whether the treatment results in ablation, cutting or coagulation at the cellular level. The mainstay of CO 2 laser is ablative tissue resurfacing; therefore, it is effective for both benign epidermal and dermal hyperpigmentation such as various benign naevi [39] .…”

“…It is characterized by redness, swelling, and pustules oozing pus around the hair follicle which leads to inflammation of the hair follicle (folliculitis) with damage to the hair follicle, and thus enduring hair loss with scarring and loss of follicular openings. It is also called TF, characterized by "polytrichia" which is multiple hairs emerging from a single dilated follicular orifice [39] . Trichoscopic findings: The hallmark is the emergence of multiple hairs from a single dilated follicular opening (5-20 or more) polytrichias with a band of yellow scales at the base of the hair, and perifollicular hyperplasia that is arranged in a starburst pattern (starburst sign) in FD [39,40] .…”

“…Trichoscopic findings: The hallmark is the emergence of multiple hairs from a single dilated follicular opening (5-20 or more) polytrichias with a band of yellow scales at the base of the hair, and perifollicular hyperplasia that is arranged in a starburst pattern (starburst sign) in FD [39,40] . According to Fabris et al, there are follicular tufts (Figure 39), perifollicular erythema (Figure 40), yellowish tubular scaling, crusts, and pustules [39] . Follicular scaling and pustules represent follicular inflammation and an active disease [10] .…”

Alopezien infolge von Medikamenten oder von anderen Haut- und systemischen Erkrankungen

“…In der Trichoskopie zeigen sich Büschelhaare, ein perifollikuläres Erythem, Verkrustungen und Pusteln. Die Behandlung richtet sich nach der Ätiologie und beinhaltet beispielsweise einzelne oder kombinierte topische oder systemische Antibiotika, Antimykotika, Retinoide oder Steroide sowie, in bestimmten Fällen, chirurgische Eingriffe [40,41,42,43,44]. …”