Folliculitis keloidalis nuchae leading to tufted folliculitis
A 34-year-old male presented with firm shiny papules on the nape of the neck and scalp of 2-year duration. The patient first developed pustules at the nape of the neck and later the present firm papules [Figure 1]. A diagnosis of folliculitis keloidalis was made and the patient was treated with intralesional triamcinolone. There was improvement. During the course of time, the patient also developed pustules at other regions of the scalp which later evolved into papules. Fearing a recurrence, the patient shaved of his entire scalp hair. Later, he noticed multiple groups of hair arising from his shaved scalp where the papules had subsided. On examination, the occipital and vertex of the scalp showed multiple tufts of hair (polytrichia) arising from a single follicular opening resembling “doll’s hair” suggestive of tufted folliculitis [Figure 2]. A final diagnosis of folliculitis keloidalis, leading to tufted folliculitis, was made.