Keratosis Follicularis Spinulosa Decalvans: A Rare Cause of Scarring Alopecia in Two Young Indian Girls
A 8-year-old female came to the clinic with complaints of hair loss over the scalp since 6 years with sparse eye brows. Hair loss was progressive in spite of trying Ayurvedic medicine and homeopathy. On examination hair density was reduced over the scalp with vellus and terminal hairs. Multiple follicular papules were seen giving roughness to the scalp [Figures and ]. Similar lesions were seen all over the back, chest wall, extensor aspects of limbs. There was no history of photophobia and ophthalmic examination showed no evidence of conjunctival/corneal involvement. Punch biopsies were taken and submitted for histopathological examination. Her 5 year old sister had similar complaints. Both the siblings were normal at birth, the above symptoms started from the age of 2 years. However, biopsy was not taken from the younger sibling. Histopathologic examination revealed hyperkeratosis and mild acanthosis of epidermis with follicular plugging and dilated infundibulum []. The dermis revealed perifollicular lymphocytic infiltrate with eccentric epithelial atrophy, polytrichia, and perifollicular fibrosis []. Periodicacid Schiffs (PAS) stain done did not show any fungal organisms. Considering family history and clinical features, a diagnosis of KFSD was offered.