Pseudofolliculitis barbae: a dermatoscopic correlate

A 45-year-old man presented with a slightly tender rash on his face of about three months’ duration. Past medical history was non-contributory. Physical examination revealed a solitary 1 cm erythematous nodule in the right submental area. Dermatoscopy showed a structureless pattern with a gray-blue, thick, curved line and adjacent red lines (Figure 1), which appeared to be a subcuticular suture, although the patient had no prior surgeries. A #22-gauge needle was used to unroof the nodule, revealing five black, coiled, beard hairs nestled deep into the dermis (Figure 2), the longest measuring 6 cm in diameter (Figure 3). These findings were most consistent with a diagnosis of pseudofolliculitis barbae accompanied by a characteristic foreign-body-like reaction to the retained hairs.