Folliculitis Decalvans: An Uncommon Case Report with Review of Literature

Folliculitis decalvans (FD) is a rare, chronic inflammatory disorder that primarily affects the scalp, leading to scarring alopecia. The condition is classified as a primary neutrophilic cicatricial alopecia and is characterized by pustules, erosions, and scaly-crusty lesions, often associated with pain, itching, and burning sensations. The pathogenesis is not fully understood, though <i>Staphylococcus aureus</i> infection and immune dysregulation are implicated. FD is a challenging condition to diagnose and manage due to its similarities with other scarring alopecias such as dissecting cellulitis, central centrifugal cicatricial alopecia, and lichen planopilaris. We report the case of a 40-year-old female presenting with itchy follicular papules and patchy hair loss over the frontotemporal region. This rare case highlights the clinical and histological features of FD and the importance of differentiating it from other scarring alopecias to ensure appropriate treatment.