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An adolescent girl presented with a 6-month history of itchy alopecic patches with pus discharge involving the crown area of the scalp (figure 1A). She had received 3 months of oral doxycycline for a presumed diagnosis of folliculitis decalvans, with minimal improvement. Her hair was easily pluckable and breakable, and there was no regional lymphadenopathy. On visualisation of the scalp using handheld dermoscope at 10× magnification, no significant finding was noted in areas of alopecia. Interestingly, we found coiling of hair (figure 2A) assuming the shape of corkscrews at the hair-bearing margins of the alopecic patch. Numerous refractile bodies were demonstrated with 10% potassium hydroxide mounting (figure 2B). After 6 weeks of treatment, regrowth of hairs was noted, and there were no new patches of alopecia (figure 1B).
Contributors All authors have equally contributed to the clinical diagnosis and management of the patient. MRT has drafted the manuscript. DD and KV have critically revised the manuscript.
Funding None declared.
Competing interests None declared.
Patient consent Obtained.
Provenance and peer review Not commissioned; externally peer reviewed.