Recurrent inverse necrotizing infundibular crystalline folliculitis

Abstract

AbstractNecrotizing infundibular crystalline folliculitis (NICF) is a rare type of necrotizing folliculitis. The disease typically manifests as folliculocentric papules arising in a seborrheic distribution. Only 23 cases exist in the literature. Most reported cases have arisen spontaneously, but a small number of drug‐induced cases in the setting of epidermal‐derived growth factor, vascular endothelial‐derived growth factor, or PD‐1 inhibitor therapy have been reported. Colonization by bacteria and/or yeast occurs frequently. The etiology remains unknown, but some suggest a complex interplay with an aberrant microbiome, sebaceous gland dysfunction, and perturbed EGFR signaling in follicular infundibula. Histopathologic findings include rupture of follicular epithelium, neutrophilic inflammation, and nodular cup‐shaped crystal deposits. We present a case of spontaneous, recurrent NICF in an inverse pattern in the inguinal region.