Elizabeth Rafferty, MD Robert Brodell, MD Louisiana State University School of Medicine, Shreveport (Dr. Rafferty); University of Mississippi Medical Center, Jackson (Dr. Brodell); University of Rochester School of Medicine and Dentistry, New York (Dr. Brodell) rbrodell@umc.edu
DEPARTMENT EDITOR Richard P. Usatine, MD University of Texas Health Science Center at San Antonio
Dr. Brodell serves on speaker’s bureaus for 3M/ Graceway Pharmaceuticals, GlaxoSmithKline/Stiefel, Dermik/BenzaClin, Galderma Laboratories LP, Medicis, Novartis Pharmaceuticals Corporation, PharmaDerm, Sanofi-Aventis, Veregen, and AbbVie. He has served as a consultant for F. Hoffman- La Roche AG and Galderma Laboratories LP, and has performed multicenter clinical trials for Abbott Laboratories, Dow Pharmaceutical Sciences, Galderma Laboratories LP, and Genentech. Dr. Rafferty reported no potential conflict of interest relevant to this article.
After a haircut, this 15-year-old boy developed papules and hair loss on the back of his head. The fact that he was African American helped us to zero in on the diagnosis.
A 15-year-old African American boy with no previous medical problems presented with a 2-month history of hair loss and pruritic papules on the occipital scalp that had developed after a barber shaved the area. Physical examination revealed 2 dozen 1 to 2 mm keloidal papules on the posterior neck and occipital scalp with areas of focal crusting (FIGURE).
The patient had no history of trauma or previous keloid/hypertrophic scar formation. However, he had a similar episode a year earlier after shaving the same area. During that occurrence, the papules had cleared one month after applying rubbing alcohol.
WHAT IS YOUR DIAGNOSIS? HOW WOULD YOU TREAT THIS PATIENT?
