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SCALP ACNE Acne Necrotica Miliaris Variants of a pustular folliculitis affecting the scalp in adults. I) Acne Necrotica Miliaris - The superficial form of this disease. Acne Necrotica Miliaris ( syn proprionibacterium ) The superficial form of this disease presents as numerous small vesico-pustules on the scalp often at the central/posterior vertices associated with staphylococcus aureus, demodex folliculorum (tiny mites which live in the hair-follicle), yeasts of malassez. Pruritus may co-exist. The pustules rupture leaving a crust (often the only diagnostic feature). Patients are often adult males in middle age. Culture may indicate the presence of Corynebacterium (Propioni-bacterium) or Staphylococcus Aureus. Follicular necrosis usually results Presenting as numerous small vesico-pustules on the scalp often at the central/posterior vertices. Pruritus may co-exist. The pustules rupture leaving a crust (often the only diagnostic feature). Patients are often adult males in middle age. Culture may indicate the presence of Corynebacterium (Propioni-bacterium) or Staphylococcus Aureus. Follicular necrosis usually results. 2) Acne necrotica varioliformis - the deeper scarring form of the disease. Presenting as inflammatory pruritic follicular papules which rupture leaving a crust and scarring.
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