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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      community I am a dermatologist with a clinical interest in alopecia. AMA

      in Will treatment work for me? 2 years ago
      In this conversation, 4990 discussed various treatments for hair loss, including oral minoxidil, PRP, transplan, Jak inhibitors, Dutasteride, Finasteride, Olumiant, Ketoconazole, RU58841, microneedling, baricitinib, and CCCA. They recommended scalp biopsies in unclear cases of DUPA, twice weekly to twice daily shampooing for topical minoxidil users, and two sessions spaced one month apart with follow up at month three to determine the effectiveness of PRP treatment.

      community Losing Hair on Dutasteride? You might have LPP

      in Research/Science  94 upvotes 3 weeks ago
      Men with hair loss might have lichen planopilaris (LPP), which can mimic androgenetic alopecia, leading to misdiagnosis and ineffective treatment with finasteride or dutasteride. Proper diagnosis, including biopsies, is crucial to distinguish between androgenetic alopecia and conditions like LPP.
      If You Have DUPA, PLEASE READ THIS: Everyone Should Be Scalp Biopsied

      community If You Have DUPA, PLEASE READ THIS: Everyone Should Be Scalp Biopsied

      in Research  830 upvotes 7 months ago
      Scalp biopsies are crucial for diagnosing hair loss conditions like Diffuse Unpatterned Alopecia (DUPA) and retrograde hair loss, as treatments like finasteride and dutasteride may not be effective if other conditions are present. Combining PPAR-GAMMA agonists with retinoids could improve treatments for conditions like Lichen Planopilaris.

      community Totally confused by doctors opinions, would appreciate some clarity

      in Treatment  1 upvotes 3 months ago
      The user is experiencing hair loss and confusion over conflicting medical advice, with treatments including minoxidil, finasteride, and topical corticosteroids. They are unsure about the necessity of a biopsy and the timing of using minoxidil, while also considering the impact of potential androgenetic alopecia and telogen effluvium.

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