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Follicular Mucinosis developing in a patient with Folliculitis Decalvans

Folliculitis Decalvans (FD) is a form of inflammatory scarring alopecia; its causative mechanism is not well understood. It affects both sexes, may start in adolescence or adulthood and occurs more commonly in African Americans compared to Caucasians. A 44 year old man presented with scarring alopecia with erythematous papules and pustules on the right posterior occipital scalp. The histopathologic findings from the punch biopsy showed ruptured folliculitis with heavy perifollicular chronic inflammation. Histology showed well developed follicular mucinosis with a moderately heavy inflammatory cell infiltrate. The interstitial infiltrate was heavy and composed of lymphocytes and eosinophils and a few neutrophils, well below the epidermis with no epidermotropism.

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