Differential diagnosis of the scalp hair folliculitis

Area of Science:

• Dermatology
• Pathology

Background:

• Scalp hair folliculitis is a common dermatological condition.
• It poses significant diagnostic and therapeutic challenges due to a lack of clear guidelines.
• Inflammatory conditions of the scalp pilosebaceous follicle often manifest as folliculitis.

Purpose of the Study:

• To summarize prominent variants of inflammatory scalp hair follicle diseases.
• To provide differential diagnoses for scalp folliculitis.
• To outline associated histological features for accurate diagnosis.

Main Methods:

• Review of existing literature on scalp folliculitis.
• Classification based on histological findings into infectious, noninfectious, and perifolliculitis groups.
• Emphasis on the necessity of histological confirmation for diagnosis.

Main Results:

• Folliculitis can be caused by numerous infective agents (bacteria, viruses, fungi) and noninfective causes.
• Several noninfectious diseases mimic scalp hair folliculitis (e.g., folliculitis decalvans capillitii, lichen planopilaris).
• Histological findings support a three-group classification: infectious, noninfectious, and perifolliculitis.

Conclusions:

• Accurate diagnosis of scalp folliculitis often requires histological confirmation beyond clinical presentation.
• Understanding the diverse variants and their histological characteristics is essential for effective management.
• Further research may lead to standardized diagnostic and therapeutic guidelines.