Alopecic Scalp Cysts Following Isotretinoin

This case report describes a 17-year-old female who developed alopecic scalp cysts after starting isotretinoin for nodulocystic acne. Three weeks into treatment, she presented with three asymptomatic cystic swellings on her scalp, accompanied by hair loss. The condition was managed with oral prednisolone, erythromycin, and continued isotretinoin, leading to the flattening of the cysts and hair regrowth. The case suggests a possible hypersensitivity reaction to isotretinoin, termed pseudo-acne fulminans, which is rare and typically involves the face and trunk, not the scalp. The treatment regimen proved effective, highlighting the need for awareness of this potential side effect in patients with scalp comedones undergoing isotretinoin therapy.