Chronic non-scarring Folliculitis among Saudi adult patients: clinicopathological features and literature reviews.,

Chronic non-scarring folliculitis among Saudi adult patients: clinicopathological features and literature review

Fahad Al Saif, M.D

Consultant Dermatologist, Department of Dermatology, College of Medicine, King Saud University, Riyadh, Saudi Arabia

ABSTRACT

Background: Recurrent scalp folliculitis remains a challenging situation for dermatologists and patients due to the lack of exact guidelines and the hypotheses regarding causative factors. There are very limited data on patients with chronic non- scarring folliculitis in Saudi Arabia.

Objective: To assess the etiology and factors associated with chronic non-scarring folliculitis among Saudi adult patients. Methods: From October 2012 to September 2015, we performed a prospective study at King Khalid University Hospital, Riyadh, Saudi Arabia. Patients with scalp folliculitis were invited to participate in the study. Diagnosis of chronic non- scarring folliculitis was done clinically and confirmed by swab from the lesion for Gram’s staining, scraping for KOH mounting, and biopsy for cultures and histopathology.

Results: 22 patients with chronic non-scarring folliculitis were enrolled in the study during the three-year study period. The mean age was 29.9 ± 12.7 years old. Of these, 77.3% were males and 22.7% were females. Mean duration of the condition was 4.4 ± 5.0 years. 100% had active erythematous pustules and excoriated papules. All the patients had an oily scalp. Eight patients had a history of acne vulgaris. No post-lesional scarring was present. KOH examination was positive in one patient. Staphylococcus aureus, Pityrosporum ovale and Demodex folliculorum were identified in three patients. The important histopathological findings were acute neutrophilic folliculitis in 84.4% of the patients and perivascular lymphocytic infiltration, eosinophils, and foreign body giant cell reaction in 16.6% of the patients.

Conclusion: Chronic non-scarring folliculitis is not a rare scalp dermatosis, but the diagnosis is challenging because of overlapping features, both clinically and histopathologically. Increased incidence among male patients and association with oily scalp without seborrheic dermatitis or acne vulgaris, make chronic non-scarring folliculitis a unique entity. Whether it constitutes a separate disease entity or a variant of acne vulgaris, it requires further investigation

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Chronic non-scarring Folliculitis among Saudi adult patients: clinicopathological features and literature reviews.,

, Fahad Alsaif . 2015

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