A 36 year old male patient with these unilateral follicular lesions of 4 months duration over the shin. What is your diagnosis?
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Is it occupational?oil or application of greasy liniments can cause such lesions.
No history of exposure to oil or other industrial chemicals. Moreover the lesion is unilateral.
Other D.D.s
1.Friction related
2.folicular l. p.
3.follicular mucinosis
Is it pruritic? There is alopecia.
I would give moisturiser in the day and retinoic acid 0.025 % in the night along with oral vit A. then if no response I will go for biopsy.
Thanks for the suggestions.
The lesion was pruritic but no alopecia. My first impression too was follicular LP.
The ddx for a non-inflammatory follicular eruption would be
Keratosis pilaris
lichen spinulosa,
follicular LP,
hypovitaminosis A, and
patchy pityriasiform lichenoid eczema.
For the inflammatory follicular lesion in this location I would consider folliculitis and DCPA if the eruption heals with atrophy.