Tufted Hair Folliculitis

Tuftes hair folliculitis was described in 1978 by Smith and Sanderson. It is an uncommon, inflammatory, exudative, chronic and relapsing disease, located in the hair of scalp. The abnormal hairs appear in bunches (tufted) of 10 to 15 elements, irregularly distributed in evolutive plaques of cicatrizial alopecia. The clinical aspect is very peculiar and clearly different from any other type of alopecia. Initially plaques of erithema and aedema with pustules and exudation, desquamation, scales and crust appear. The evolution goes towards the fibrosis, scarring and irreversible cicatrizial alopecia. A man 34 years old is presented suffering from three years ago of plaque, oral shaped, of 8×6 cm. of diameter located in the vertex and of the scalp. That lesion was lightly erythematous and finely scaly. Many follicles irregularly distributed in the plaque, were clearly purulent. From these follicles emerged bunches of 10 to 15 assembled terminal hairs. The consistence of the plaque was firm indicating a dermal fibrosis. Diagnosis, evolution, and oral treatment with isotretinoin and cloxacilin are commented.