Persistent Pemphigus Vulgaris Showing Features of Tufted Hair Folliculitis

Pemphigus vulgaris is an autoimmune blistering disease that commonly involves the scalp. Lesions of pemphigus vulgaris that persist on the scalp for a long period may be accompanied by tufted hair folliculitis. Only two previous accounts of tufted hair folliculitis developing in a lesion of pemphigus vulgaris have been reported. We report a 51-year-old-man with erosions and clusters of hair on the scalp. The scalp lesion had persisted for about 20 years. A histopathological examination of the skin lesion on the scalp revealed separation of the epidermis and clusters of several adjacent hair follicles. The patient was diagnosed with persistent pemphigus vulgaris of the scalp showing features of tufted hair folliculitis.

A Case of Tufted Hair Folliculitis after Scalp Injury / 대한피부과학회지

Tufted hair folliculitis is a progressive, recurrent and inflammatory disease of the scalp characterized by a tufted appearance of the hairs and may result in permanent scarring alopecia. A 41-year-old man presented with tufted hairs within a 3x4cm sized indurated cicatrical patch which is getting wider. He had a scalp laceration history to the lesion 1 year ago. Histopathologic findings showed widened follicular infundibulum, dense perifollicular inflammatory cell infiltrations and dermal fibrosis. We report a case of tufted hair folliculitis developed secondarily to the scalp injury.

A Case of Tufted Hair Folliculitis / 대한피부과학회지

Tufted hair folliculitis is an inflammatory disorder of the scalp characterized by a peculiar tufting of hair within areas of scarring alopecia. Histopathological studies reveal perifollicular inflammation around the upper portions of the follicles sparing the hair root level. Within areas of inflammation, several follicles converge toward a common follicular duct with a widely dilated opening. The cause of tufted hair folliculitis is unknown, and the therapeutic approach is problematic. We present herein a patient with a 28-year history of recurrent and progressive tufted hair folliculitis. A 33-year-old man was referred to our department for the treatment of chronic and relapsing inflammatory lesions of the scalp. The clinical examination revealed a circumscribed area of 15cm length and 10cm width on the occipital area of the scalp which was characterized by hair tufting and exudates. Histopathologic findings were typical for tufted hair folliculitis. We believe that hair tufting is a secondary phenomenon which may occur in several inflammatory diseases of the scalp.

Two Cases of Tufted Hair Folliculitis

Tufted hair follliculitis is a localized, inflammatory and exudative disease of the scalp characterized by a tufted appearance of the scalp hairs emerging from single follicular openings, and may result in permanent and irreversible scarring alopecia. We report two cases of tufted hair folliculitis in a 53-year-old woman and a 47-year-old man. They had several areas of scarring alopecia with multiple bundles of hairs emerging from single follicular orifices. Histopathologic findings were typical for tufted hair folliculitis. The patients were treated successively with oral antibiotics and with topical application of clindamycin.