摘要患者男,24岁.因头皮脓疱、萎缩性瘢痕伴脱发6年.皮肤科检查:头皮弥漫性秃发伴萎缩性瘢痕.头顶仅残留少数头发,发根处有角化性丘疹、脓疱或黑色痂,前额、颞、枕部近发际处尚有部分头发,枕部头发成小簇,发根处见角化性丘疹.眉弓有红斑、鳞屑及毛囊角化性丘疹,眉毛稀疏、脱落.腋毛也稀疏.两颊、腋、胸、腹、后背、四肢均有明显毛囊角化性丘疹.口腔科检查:上下前牙排列间隙过大,上前牙前倾,(+1)先天性缺失,前牙深覆(牙合),深覆盖.沟纹舌,丝状乳头消失.皮损组织病理:表皮棘层增厚,毛囊周围可见大量浆细胞、中性粒细胞及多核巨细胞浸润.结合临床及组织病理表现,符合棘状秃发性毛囊炎的诊断.

abstractsA 24-year-old man presented with a 6-year history of pustules,atrophic scars,and alopecia of the scalp.Dermatological examinations showed generalized alopecia and atrophic scarring of the scalp.A few hairs remained at the vertex region with keratotic papules,pustules,or black sears around the hair follicles.There were also residual hairs at the forehead,temples,and occipital region near the hairline.Clusters of hairs were noted in the occipital region,and keratotic papules were observed around the hair follicles.Erythema,scales,and follicular keratotic papules were found in the superciliary arch.The eyebrows and axillary hairs partially shed and were sparse.Follicular keratotic papules were also found on both cheeks,axillae,chest,abdomen,back and limbs.Stomatological examinations revealed a large space between the upper and lower anterior teeth,anteverted upper anterior teeth,congenital absence of (+1) tooth,deep overbite and deep overjet of anterior teeth.He had a fissured tongue which lacked filiform papillae.Pathological examinations of the skin lesions showed a thickened spinous layer and massive infiltrations of plasmacytes, neutrophils, and multinucleated giant cells around hair follicles.A diagnosis of folliculitis spinulosa decalvans was made based on the clinical manifestations and histopathological findings.