Case Number : CT0077 Adam_Bates

I'm guessing Langerhans cell histiocytosis.  Need IHC, though.

I think of LCH ,too. CD1a will help.
 

Nice and typical clinical presentation with an infectious like pattern on the scalp.

Folliculocenteric LCH, marvelous case :-)
 

Yes this is folliculocentric langerhans cell histiocytosis. It is quite an unusual pattern of LCH as most localised forms of LCH show diffuse demal infiltrate of Langerhans cells and present as solitary nodule or papules. This case had an exclusive folliculocentric pattern and hence the clinical impression of ?folliculitis decalvans ?LPP...the histological diagnosis came as quite a surprise to the dermatologists. The patient has no other lesions and is well otherwise. See link below for a strikingly similar case report. http://www.ncbi.nlm.nih.gov/pubmed/15024194