Uchiyama M, et al. - Researchers performed a case series study to clarify the histopathological and dermoscopic characteristics of early and advanced active stage folliculitis decalvans (FD), a form of inflamed primary cicatricial alopecia (PCA). The sample consisted of 42 patients with FD by dermoscopy and both horizontally and vertically sectioned biopsy specimens. Early-stage lesion histopathological findings included loss of sebaceous glands, interfollicular acanthosis, and fibrosis with depressed, fused follicular infundibula indicating thickened interfollicular keloid-like areas with tufted hair on dermoscopy. Active lesions showed a greater number of hair clusters, clefting, and fused infundibula with dense inflammation predominantly in the upper follicles. In less than half the patients, including those with early-stage lesions, neutrophil-predominant infiltrates were detected. Findings suggested that FD has mixed cell-PCA features.