ABSTRACT

Tufted hair folliculitis (THF) is an uncommon, persistent and progressive folliculitis of the scalp that resolves with irregular areas of scarring alopecia within which plentiful hair tufts come out from dilated follicular orifices. Tufting of hair is caused by clustering of adjacent follicular units due to a fibrosing process and to retention of telogen hairs within a dilated follicular orifice. To date numerous pathogenetic mechanisms have been suggested about the development of tufted folliculitis including nevoid abnormalities, local trauma and recurrent infections of the follicles. However, the exact pathogenesis of THF is not fully understood because of the rare incidence of THF.Here we present a 40-year-old man with tufted folliculitis on the vertex and parieto-occipital region of the scalp and acne keloidalis nuchae on the nape and review the literature about the pathogenetic mechanisms of this disease whether it is a specific disease or secondary phenomenon that may arise in several different inflammatory disorders of the scalp.