A case of folliculitis decalvans with tufted hair

A 70-year-old man presented with an area of scarring alopecia measuring 5 X 8 cm with tufts of hair over the parietal to the right occipital region. At the age of 50, the patient had received a ventriculo-peritoneal shunt for hydrocephalus after an aneurysm of his right vertebral artery. About one year after that operation, he developed a pustule-like eruption in the parietal area where a cerebral ventricle catheter had been placed. Since then he had undergone various kinds of treatment unsuccessfully. Culture plates grew Staphylococcus aureus. The patient was successfully treated with topical clindamycin, butyric acid propionate betamethazone and oral roxithromycin and has improved.