Parker Altaaf, Parker Masood Ahmed, Schneider Johann, Jordaan Henry, Visser Willem
Dermatology, Stellenbosch University Faculty of Medicine and Health Sciences, Cape Town, South Africa.
Anatomical Pathology, University of Stellenbosch and National Health Laboratory Services, Cape Town, South Africa.
Int J Dermatol. 2023 Nov;62(11):1371-1377. doi: 10.1111/ijd.16847. Epub 2023 Sep 21.
Folliculitis keloidalis (FK) is a chronic hair disorder commonly affecting males with afro-textured hair. It typically affects the nuchal area, but disease may also occur at extra-nuchal sites. Few studies have investigated the histopathological aspects of preclinical FK. In addition to the histopathology of preclinical FK, this article is the first to describe the dermoscopic features of preclinical FK at extra-nuchal sites.
This study was conducted in a tertiary dermatological clinic. Twenty-eight patients with a clinical diagnosis of FK were prospectively enrolled from 2014 to 2016. Dermoscopy was used to identify features that were not evident with the naked eye (preclinical). These sites were subsequently biopsied. The clinical, dermoscopic, and histopathological features of these preclinical areas are described and correlated.
Most patients suffered a chronic disease course (mean: 7.6 years) with 57.1% (n = 16) displaying extra-nuchal involvement. Dermoscopy-guided biopsy of preclinical lesions displayed perivascular dermatitis (82.1%), folliculocentric inflammation (46.3%), and fibrosis (64.3%). Novel dermoscopic findings were perifollicular scale, perifollicular erythema and pink-white areas. The perifollicular scale was associated with fibrosis on histopathology (P < 0.05).
This article lends further evidence for the existence of preclinical FK and describes its histological features. For the first time, it describes the dermoscopic features of preclinical FK. Dermoscopy may therefore be a useful tool to assess disease progression and treatment response.
瘢痕疙瘩性毛囊炎（FK）是一种常见的慢性毛发疾病，通常影响具有非洲裔毛发质地的男性。它通常累及颈部区域，但也可能发生在颈部以外的部位。很少有研究调查临床前FK的组织病理学方面。除了临床前FK的组织病理学外，本文首次描述了颈部以外部位临床前FK的皮肤镜特征。
本研究在一家三级皮肤病诊所进行。2014年至2016年前瞻性纳入了28例临床诊断为FK的患者。使用皮肤镜识别肉眼不可见的特征（临床前）。随后对这些部位进行活检。描述并关联了这些临床前区域的临床、皮肤镜和组织病理学特征。
大多数患者病程慢性（平均：7.6年），57.1%（n = 16）有颈部以外的受累。临床前病变的皮肤镜引导活检显示血管周围性皮炎（82.1%）、毛囊中心性炎症（46.3%）和纤维化（64.3%）。新的皮肤镜表现为毛囊周围鳞屑、毛囊周围红斑和粉白色区域。毛囊周围鳞屑在组织病理学上与纤维化相关（P < 0.05）。
本文为临床前FK的存在提供了进一步证据，并描述了其组织学特征。首次描述了临床前FK的皮肤镜特征。因此，皮肤镜可能是评估疾病进展和治疗反应的有用工具。
