A 70-year-old man complained of a chronic folliculitis on for the occipital scalp for 30 years. He eventually developed a transverse fibrotic scar with scattered tufts of hair giving a "doll's hair" appearance. Tufted hair folliculitis is a rare progressive pattern of scarring alopecia characterized by the presence of groups of multiple hairs emerging from a single follicular opening. The cause of this disorder is unknown, but tufted hair folliculitis has been described in patients with acne keloidalis nuchae like in this case, scars from surgery or trauma, folliculitis decalvans, dissecting cellulitis of the scalp, lichen planus, and pemphigus vulgaris.
transverse fibrotic band with multiple hairs emerging scattered preserved follicular openings