Keratosis Pilaris and Scarring Alopecia

A 28-year-old man experienced scarring alopecia on his scalp and possible folliculitis on his limbs and trunk for over 10 years, with no improvement from various topical treatments. He had a family history of keratosis pilaris, and all family members had straight hair, while his remaining scalp hair was excessively curly. Physical examination revealed an 8-cm area of scarring alopecia with follicular scaling papules and pustules on the scalp, and 1- to 2-mm erythematous follicular keratotic papules on the trunk, arms, and legs. His palms and soles showed mild diffuse keratotic thickening. Seven years prior, he was treated with oral vitamin A without lasting benefit.