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Fake sun tan diagnosis of porokeratosis

The clinical features in this case were striking. Keratosis pilaris on the arms, follicular papules on the cheeks, clumps of folliculitis and progressive scarring alopecia of the scalp are all features of keratosis follicularis spinulosa decalvans group. Recurrent bouts of painful tufted folliculitis may also occur in folliculitis decalvans. However, in folliculitis decalvans, the inflammation is confined to the scalp. Our patient has the salient clinical features of keratosis follicularis spinulosa decalvans as reported by other authors (Table 1). Despite all treatments, the natural course of the disease appears to be one of progressive destruction of the hair follicles and expansion of the scarred area. In conclusion, a patient with a progressive inflammatory scarring scalp disorder, with keratinous cases of hair shafts, extensive keratosis pilaris and facial erythema, is reported. These findings are consistent with a diagnosis of folliculitis spinulosa decalvans. This condition has proved resistant to a prolonged trial of treatment with isotretinoin and courses of oral antibiotics.