This man had long standing discoid lupus of the face and the scalp. This has not been treated for some time and shows follicular plugging. Often in discoid lupus of the scalp there is attached scale which when removed shows the carpet tack sign with follicular keratinisation attached to the undersurface of the scale.
He was treated with sun protection and a steroid lotion and this quickly resolved. Discoid lupus of the scalp will cause a scarring alopecia.
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