2022 Volume 21 Issue 3 Pages 235-239
The patient was a Japanese 24-year-old male. He presented with a firm tumor on his occipital scalp one year prior to first visit to our hospital. On the firstvisit,a firm, keloid-like protuberant tumor was observed on his occipital scalp. Numerous hairs emerging from common follicular orifices, forming tufted hairs, were also seen in the cicatricial alopecia lesion. Surgical excision of the tumor was performed at the level of superficial fascia with reconstructive surgery by the advancement-rotation flap because local treatments with intralesional corticosteroids failed to reduce the size of the tumor. Histology of lower magnification of the tumor revealed loss of sebaceous glands, and infiltrations of inflammatory cells in the superficial to mid-dermis with interfollicular diffuse dermal fibrosis and preserved lower parts of follicles in the deep dermis to the subcutis. Proliferated, dilated capillary vessels with infiltrate of inflammatory cells and prominent stromal fibrosis, forming granulation tissue, and destruction of follicular epithelium were observed. Based on these findings, the patient was diagnosed as folliculitis keloidalis. The lesion was healed after surgical treatment, and no recurrence was seen. Pathogenesis of the disease and utility of surgical treatments are discussed. Skin Research, 21 : 235-239, 2022
