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June 1995

A Young Adult With a Recalcitrant Scalp Folliculitis

Author Affiliations

University of Illinois—Chicago (Drs Guitart and Micali) and Tripler Army Medical Center, Honolulu, Hawaii (Dr Norton)

Arch Dermatol. 1995;131(6):721-722. doi:10.1001/archderm.1995.01690180097018

REPORT OF A CASE  A 27-year-old man presented with a 2-year history of pruritic, scaly papules unresponsive to oral erythromycin. The papules began on his scalp and after a few months spread to his chest and upper arms. His personal and family history were negative for hair or scalp disorders, psoriasis, or cancer. The patient also complained of polydypsia and polyuria for the 4 to 5 months before presentation.Physical examination revealed numerous follicular-based erythematous crusted papules, mostly on the scalp (Figure 1 and Figure 2) with a few scattered on the trunk. Mild diffuse hair thinning of the scalp was present with no evidence of a scarring process or pustules. Otherwise, the physical and neurologic examination was unremarkable. The patient was treated with dicloxacillin, rifampin, topical clindamycin, and coal tar shampoo for a presumed diagnosis of acne necrotica miliaris, but his condition did not improve. The serum electrolytes, general

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