Having some discoloration on the back of the scalp. Could it be folliculitis?

Patient's Query

Hi doctor,

I shave my head with a razor blade once in a few days as if shaving my face. I have been doing this for seven years now.

Four years ago, my doctor noticed that I had a discoloration on the back of my scalp. He said it was nothing to worry about and had probably always been there like a birthmark.

Now, a few years later, it has never actually gone away. It has become bigger, more pronounced and red all the time. It does not itch ever, but it does stay red and feels rougher than the normal skin to touch.

It just looks like a bright red rash that never goes away. It does not turn scaly or white and also does not flake off to my knowledge.

I do not have a lot of anxiety over it, but it is extremely embarrassing to the point where I do not show my full head a lot in the public.

Could it be folliculitis? Could that last for years? Please help.

Answer

Dr. Suvash Sahu

Cosmetology Dermatology Venereology

Hi,

Welcome to icliniq.com.

I have seen your query and concern.

I have examined your pictures (attachment removed to protect patient identity). It seems that you are having non-involuting congenital hemangioma (NICH).

NICH present at birth and usually flatter, presented as well defined round to oval, slightly indurated mass with overlying visualized deeper blood vessels (telangiectasias) and a rim of pallor.

You can get ultrasonography with color Doppler to rule out arteriovascular malformation.

NICH do not go away, often asymptomatic and may require excision. But, must weigh the risks and benefits of the proposed treatment.

For further information consult a dermatologist online --> https://www.icliniq.com/ask-a-doctor-online/dermatologist

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Patient's Query

Thank you doctor,

NICH and other types of birthmarks are not something that I had come across yet.

I do have one final question. Would it be possible for this to also be tinea versicolor?

It looks very similar to pictures of it and I have had some issues like seborrheic dermatitis on the face before and other oily-type rashes.

Answer

Dr. Suvash Sahu

Cosmetology Dermatology Venereology

Hi,

Welcome back to icliniq.com.

I have read your concern.

Pityriasis versicolor can be considered if it was of short duration with slight flakes and may be associated with mild itching.

Yes, seborrheic capitis may be considered since now you gave a history of seborrheic dermatitis over the face. But, with seborrheic capitis you may have moist scaling.

Better to do KOH - Potassium hydroxide mount for skin scraping and it will rule out both.

For further information consult a dermatologist online --> https://www.icliniq.com/ask-a-doctor-online/dermatologist

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