Red Scalp Disease – A Rosacea-Like Dermatosis of the Scalp? Successful Therapy with Oral Tetracycline

her scalp hair ( fig. 2 a–c). A bacterial swab revealed normal skin flora. Both patients presented with the complaint of a red scalp with itching or burning sensations and a very similar clinical presentation of erythema, telangiectasia and follicular papules and pustules of the scalp. Lesional biopsies taken from both patients showed telangiectasia, perifollicular mixed-cellular inflammation with granuloma formation ( fig. 1 c) in the mid dermis consistent with rosacea and moderate elastosis. No fungal spores were found. The direct immunofluorescence of both patients was negative. On the basis of clinical and histopathologic features of rosacea, a therapeutic trial with oral tetracyclines was done. After 6 weeks of oral lymecycline (300 mg/day), the patients reported significant improvement of their complaints. On clinical examination, erythema and follicular papules and pustules had disappeared; there remained residual telangiectasia ( fig. 2 d, e). Patients were also recommended to omit topical corticosteroids and to protect their scalp from UV exposure.