Folliculitis decalvans (Q44020)

Folliculitis decalvans is characterised by the progression of scalp folliculitis to extensive inflammation, follicular destruction and scarring. In a variant called tufted folliculitis the hairs become clumped into tufts containing a dozen or more hairs. In contrast to the course in the vast majority of people who develop a bacterial pustular folliculitis of the scalp, individuals with folliculitis decalvans appear unable to eradicate Staphylococcus aureus from the hair follicle even with appropriate antibiotic therapy. Recurrent pustulation with surrounding inflammation and scaling leads to extensive permanent scarring and loss of hair.