Despite the ubiquitous presence of acne vulgaris in adolescents and young adults, involvement of the scalp with classical acne lesions seems to be uncommon. We report two patients with alopecia areata, in whom acne developed within the alopecic areas. Patient 1. A 16-year-old girl was referred to the dermatology department with a 15-year history of alopecia universalis. In addition, she gave a recent history of facial acne for which her general practitioner had prescribed a course of oral oxytetracycline at a dose of 500 mg mg twice daily and topical erythromycin 4%/zinc 1.2% twice daily. There was an additional history of atopy, manifest as both hayfever and mild flexural eczema. The patient was otherwise well and on no other medication. On examination, there was complete scalp alopecia and absent facial and body hair. In addition, the typical lesions of acne were observed over the vertex and occipital scalp (Fig. 1).
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