Authors

Eva Krishna Sutedja ¹, Endang Sutedja ¹, Kartika Ruchiatan¹, Yuri Yogya ¹, Yogi Faldian ¹, Oki Suwarsa ¹, Risa Miliawati Nurul Hidayah ¹, Hermin Aminah Usman ², Erza Rahayu¹

Affiliations

¹Department of Dermatology and Venereology, Faculty of Medicine, Universitas Padjadjaran – Dr. Hasan Sadikin Hospital, Bandung, West Java, Indonesia; ²Department of Anatomical Pathology, Faculty of Medicine, Universitas Padjadjaran – Dr. Hasan Sadikin General Hospital, Bandung, Indonesia

Background

• Inverted follicular keratosis (IFK) is a rare benign tumor of the hair follicle, usually seen on the head and neck of older adults.

• Its true incidence is likely underreported because it is often misdiagnosed as more common skin lesions.

Methods

• Case report of a 26-year-old man with a solitary, painless, pedunculated scalp lesion that bled intermittently and grew slowly over three years.

• Evaluation included dermoscopy and histopathological examination.

Key Results

• The lesion was initially diagnosed clinically as pyogenic granuloma based on its appearance and bleeding tendency.

• Dermoscopy showed white structureless areas with central keratinous plugs and blood spots.

• Histopathology confirmed inverted follicular keratosis, showing endophytic proliferation and squamous eddies.

Discussion & Conclusion

• IFK can mimic both benign and malignant skin tumors and should remain a differential diagnosis for scalp lesions across all age groups, not just older adults.

• Recognizing its dermoscopic and histopathologic features is critical to avoid misclassification, and histopathology remains essential for a definitive diagnosis.

Related SDGs

SDG 3: Good Health and Well-Being – Improving accurate diagnosis of rare skin tumors

Journal Information

Journal: Clinical Cosmetic and Investigational Dermatology

DOI: https://doi.org/10.2147/CCID.S566801