棘状秃发性毛囊炎

Folliculitis spinulosa decalvans:a case report

报告1例棘状秃发性毛囊炎。患者男,41岁。头面部反复出现红色脓疱性丘疹伴疼痛、脱发近41年。家族中其大姐有类似疾病。毛囊性丘疹和脓疱在青春期加重,并伴有畏光、结膜干燥、睑缘炎。皮肤科检查:头皮弥漫性秃发,可见网状瘢痕形成和色素脱失。眉弓、上唇和下颌散在分布许多红色丘疹,有的丘疹顶端有脓疱。双侧眉毛、腋毛和阴毛大部分缺失,局部可见散在毛囊角化性丘疹。皮损组织病理检查:表皮萎缩,真皮可见毛囊,其周围有较多淋巴细胞、组织细胞浸润,并有纤维组织增生。结合临床和组织病理表现,符合棘状秃发性毛囊炎的诊断。

A 41-year-old male patient with follieulitis spinulosa deealvans is reported. The patient presented recurrent red pustular papules with pain and alopecia on the scalp for nearly forty-one years. His elder sister had the same history of this disease. Follicular pustular and papules aggravated in the puberty with photophobia, xeroma and blepharitis. Physical examination revealed diffused alopecia and reticular atrophic scars with depigmentation on the scalp, and sporadic red papules could be seen on the superciliary arches, the upper lip and the mandible, and pustules on the top of some papules. Most of the eyebrows, pubic and armpit hairs were absent, keratosis papules could be seen on some sites. Biopsy specimen showed epidermis atrophy, hair follicle in the dermis, which surrounded by many lymphocytes and histiocytes, and the proliferation of fibrous tissue. The diagnosis of keratosis follicularis spinulosa decalvans was made according to the clinical and histopathologic manifestations.