Tufts of Doll's Hair Within a Shiny, Scarring Alopecia

    Isadore S. Tarantino, Ryan Fischer, Anand Rajpara
    TLDR The man likely has tufted folliculitis causing painful, scarring hair loss.
    A 43-year-old Hispanic man experienced an 8-year history of painful, purulent alopecia on the scalp, which did not improve with ketoconazole shampoo or oral prednisone. Examination showed shiny, cicatricial alopecia on the vertex of the scalp with tufts of hair, firm nodules, and scarring alopecia on the neck. The most likely diagnosis was tufted folliculitis.
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