Hair digging folliculitis of the nape of the neck and occiput: Outbreak of cases following hair styling by close shaving of non-curly hair
Keywords:
Folliculitis keloidalis nuchae, Acne keloidalis nuchae, Digging folliculitisAbstract
Background Folliculitis nuchae is chronic inflammatory process of hair follicles of the nape of the neck and occiput and is usually seen in persons with curly hair of African descendants. This condition might continue for months and years that often end with keloid formation if not stopped. Objective To do full clinical evaluation of this condition in patients with non-curly hair and non-African descendants. Methods This is a cross sectional study with therapeutic trial that had been carried out during the period from 2019-2023 where all patients with folliculitis of the nape of the neck and occiput with or without keloidal formation were collected. All demographic and clinical features were screened, including all patients with Fitzpatrick's skin types III-IV. The disease process was passed in three phases according to the type of inflammatory process. In phase one, there were folliculitis, while in the second phase, there were small hypertrophic scars with some features of folliculitis and the third phase consisted mainly of keloidal papules and nodules. Treatment was applied according to the phase of the disease process; phase one, patients were treated by topical clindamycin solution with oral desloratadine 5 mg tablet twice a day and oral sulfamethoxazole/ trimethoprim (400mg/80mg) 2 tablets twice a day for two weeks, then 2 tablets a day. Phase two was managed similarly to the phase one with edition of topical steroid. Phase three included only oral desloratadine 5 mg tablet with topical mometasone cream twice a day and therapy continued for several months. Results Sixty male patients with non-curly hair were included in this study, their ages ranged from 20-45 years with mean age of 28 years while the duration of the disease ranged from 0.5-5 years. All patients gave history of very close hair short cutting and shaving of hair of back and sides of scalp and neck. Itching and scratching were practiced by all patients while pain was mentioned in 13 (21.66 %) patients. Regarding the phase of the disease, 48 (80%), 8 (13.33%) and 4 (6.66%) of patients were in phase one, two and three respectively. The response to treatment was variable and depended on the phase of the disease as phase one showed rapid and best response to treatment regimen with more satisfactory results than phase two and three. Conclusion There is major outbreak of digging folliculitis of neck among adult males with non-curly hair following hair styling by close/ short cutting and shaving of back, sides of scalp and neck hair.References
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