Folliculitis decalvans-like pustular plaques on the limbs sparing the scalp.

Folliculitis decalvans is a neutrophilic cicatricial alopecia characterised by progressive pustular folliculitis. Folliculitis decalvans is seen as a condition usually limited exclusively to the scalp and rarely affects the limbs. We present a case of a 63-year-old man with a 3-year history of progressive pustular folliculitis with inflammatory patches and central scarring alopecia on both forearms and a circumscribed patch on his right lower leg. His presentation, clinical course and isolation of Staphylococcus aureus together with the histopathological findings all supported a folliculitis decalvans-like pustular folliculitis limited to the limbs. Biopsies revealed follicular pustules, gross interfollicular fibrosis with plasma cells and concentric perifollicular fibrosis with lymphocytes, all features seen with folliculitis decalvans. The positive response to antibiotics combined with topical corticosteroids mirrored the response seen with scalp folliculitis decalvans. In contrast to the previously reported cases, the patient had no evidence of folliculitis decalvans on the scalp.

Recurrent lichenoid reaction to black tattoo ink: A case report and brief review of the literature.

Cutaneous reactions to tattoos are increasing as the prevalence of tattoos increases. Lichenoid reactions often occur in red tattoos and are usually localised to the tattoo. We present a case of recurrent lichenoid reaction occurring in both the black tattooed and adjacent non-tattooed skin.

Dystrophic calcification following neonatal heel-prick testing.

A 7-year-old boy presented with a 5-year history of dystrophic calcification manifesting as solitary nodules on the plantar aspect of both heels. Microscopic examination showed hyperkeratosis and psoriasiform hyperplasia overlying an area of dystrophic calcification. Multiple heel-prick tests carried out during the neonatal period to monitor blood glucose levels are the likely causative mechanism.

Reticulate keloidal purpura associated with transient antiphospholipid antibodies and hyperhomocysteinaemia.

A 66-year-old woman presented with a reticulate pattern of purpuric, keloidal scarring affecting her lower legs and necrosis of her left thumb and little finger as sequelae of an episode of staphylococcal septicaemia. Her premorbid past history includes three miscarriages, three episodes of pulmonary embolism and an internal iliac vein thrombosis. Skin biopsy specimens showed keloidal scar tissue in the dermis but no evidence of thrombosis or vasculitis. Blood tests demonstrated moderate hyperhomocysteinaemia. Elevated levels of anticardiolipin antibodies were found on one occasion but this was not detected on initial or repeat testing.