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Occipital scalp papules in a teenage boy

J Fam Pract. 2014 December;63(12):739-740
By
Elizabeth Rafferty, MD
Robert Brodell, MD
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After a haircut, this 15-year-old boy developed papules and hair loss on the back of his head. The fact that he was African American helped us to zero in on the diagnosis.
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A 15-year-old African American boy with no previous medical problems presented with a 2-month history of hair loss and pruritic papules on the occipital scalp that had developed after a barber shaved the area. Physical examination revealed 2 dozen 1 to 2 mm keloidal papules on the posterior neck and occipital scalp with areas of focal crusting (FIGURE).

The patient had no history of trauma or previous keloid/hypertrophic scar formation. However, he had a similar episode a year earlier after shaving the same area. During that occurrence, the papules had cleared one month after applying rubbing alcohol.

WHAT IS YOUR DIAGNOSIS?
HOW WOULD YOU TREAT THIS PATIENT?

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