Causes and risk factors
In folliculitis keloidalis, there occurs irritation of the hair shaft which results in irritation of the wall of the hair follicle, resulting in inflammation. However, this mechanism is still not clear. Some studies suggest that this is a skin condition which can be caused due to bacterial infection. Injury caused due to razor during haircuts is one of the contributing factors. This condition is commonly seen in obese people and those suffering from metabolic syndrome and those suffering from keratosis follicularis spinulosa decalvans. Irritation caused due to shirt collars or use of antiepileptic medications can also trigger this condition.
Clinical presentation:
The most common site of affection is the nape of the neck. Small red color eruptions develop particularly at the site of the hair follicle. Itching is another complaint seen. Scratching irritates the complaint. This gives way to bacterial infection. Over time these eruptions become small scars. Small scars then become keloids. These scars form a hairless band. Tufts of hair are formed out of a single follicle, multiple hair arise. Papules or pustules are formed in and around the follicle of hair.
Investigations:
Diagnosis is done on the basis of the symptoms narrated by the patient and the physical examination carried out by the dermatologist. However, routine blood test, blood cultures, or testing of the discharges along with histological examination can be done. Skin biopsy can also be done.
Treatment:
The treatment plan consists of administration of antibiotics and application of topical steroids. Hair removal therapy using laser therapy is also found to be effective. In some cases, surgical care is needed. Excision or laser vaporization or electrosurgery is done in order to remove the thickened plaques. Radiotherapy is another method which can be used. However, the complaints of folliculitis often tend to reappear in spite of the treatment.
When to contact a doctor:
Recommendation of an expert in the field of dermatology is advised in cases where the patient suffers from complaint of skin eruptions and itching particularly at the occiput region.
Prevention:
Educating the people regarding the condition is the main preventive measure to be adopted. One should avoid using tight collared shirts and athletic head gear frequently as this causes shearing of the hair.
System involved: Integumentary system
Organ involved: skin and tissues
