This webpage focuses on skin changes centered about the follicle.


Atrophoderma Vermiculatum

Folliculitis. A chronic folliculitis as well as acne can cause atrophy about the hair follicle.


A benign nevus lacks pigment in the perifollicular areas. If the hair is near an edge, this may give a notched appearance incorrectly suggesting atypia [AD 1992;128;514].

Papules/Keratotic Papules/Spines

Lichen Spinulosus

Follicular Eczema
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Disseminate And Recurrent Infundibulofolliculitis
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Ichthyosis Follicularis: Extensive noninflammatory follicular hyperkeratosis, photophobia, and a widespread non-scarring alopecia. Perineal red, scaly plaques [PD 7;287]. Graham Little Piccardi Lassueur Syndrome
Keratosis Pilaris

Keratosis Follicularis Spinulosa Decalvans

Papular Acne Scars

Pityriasis Rubra Pilaris


Pilotropic CTCL

Multiple Minute Digitate Deratoses Hundreds of tiny, spiked keratotic papules scattered on the trunk and limbs.

Lichen Planopilaris and specifically Graham-Little Piccardi Lassueur Syndrome

Lichen Scrofulosorum

BRAF Inhibitor. A keratosis pilaris rash may erupt. [Dermatology Online Journal]

Middermal Elastolysis

Acne Scars


Viral Folliculitis

Traumatic Anserine Folliculosis. Traumatic anserine folliculosis is a curious follicular hyperkeratosis that may result from persistent pressure and lateral friction of one skin surface against another.


Pityriasis Rubra Pilaris. Rarely, dramatic follicular plugging may occur in pityriasis rubra pilaris leading to keratotic spines [JAAD 23;527(CP)]. Keratotic papules may occur after irradiation [Poster 2000 AAD 243].

Trichodysplasia Spinulosa

Multiple Myeloma. Follicular spines may rarely occur in association with multiple myeloma. The trichodysplasia spinulosa virus is not related [JAMA Derm 2015;151;82-4].

A Demodex folliculorum-associated spinulosus has been reported in which patients develop multiple follicular spines and may complain of a rough sandpaper feel to the skin [JAMA Derm 2015;151;1251].


Follicular Accentuated small vessel vasculitis

Scurvy. Photograph courtesy Eliot Mostow, MD
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Tufts of Hair

Trichostasis Spinulosa
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Normolipemic Plane Xanthomas


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