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A Case for Diagnosis (Folliculitis Decalvans?). Presented by Dr. J. Frank Fraser.
Mrs. E. S., aged 54, gave a history of injury to the scalp in July, 1932. The wound healed but remained painful. There were occasional ulcers and crusts. The patient has an area of cicatrization and alopecia the size of a palm on the vertex of the scalp, with a few small crusts.
Dr. Frank C. Combes: Three possible diagnoses are suggested for this condition: lupus erythematosus, folliculitis decalvans and, possibly, dermatitis artefacta with a secondary infection. At present the patient shows no folliculitis, and the shape of the patch does not suggest folliculitis decalvans. The erythematous border and the patulous follicles that would be expected in a case of lupus erythematosus are absent. There are a few superficial crusts but no scales. The case suggests intentional prolongation of the original injury, which has entirely healed.Dr.