A Case of Folliculitis Decalvans With Concomitant Acne Keloidalis Nuchae, Androgenic Alopecia, and Profound Postinflammatory Hyperpigmentation

The document presented a detailed review of folliculitis decalvans (FD), including its pathophysiology, clinical manifestations, diagnosis, and treatment, illustrated by a case study involving a patient with concomitant acne keloidalis nuchae, androgenic alopecia, and profound postinflammatory hyperpigmentation. FD predominantly affected middle-aged African American men and was characterized by red patches of scarring and follicular hyperkeratosis, primarily on the scalp. Staphylococcus aureus was implicated in its pathogenesis. Effective first-line therapy included oral tetracyclines, with severe or refractory cases requiring combination antibiotic therapy. The document also highlighted the importance of treating underlying inflammatory conditions to manage postinflammatory hyperpigmentation.