Botulinum Toxin A as an Alternative Treatment for Folliculitis Decalvans

The document presents a case study of a 34-year-old male patient with folliculitis decalvans, a scalp disorder characterized by scarring alopecia and permanent hair loss, who did not respond to conventional treatments such as antibiotics and corticosteroids. The patient was treated with 4 intradermal sessions of 100 IU of botulinum toxin A over a period of 90 days. The patient reported improvement in inflammatory lesions and elimination of itch within a few days, and full remission of the disorder was observed 4 months after initial treatment. The patient's condition was continuously monitored for 5 years, with no relapse of the disease observed during this period. The study suggests that botulinum toxin A could be an effective alternative treatment for folliculitis decalvans, possibly due to its action on the patient’s immune response. However, the exact mechanism behind the healing effect of botulinum toxin A on folliculitis decalvans is still unknown.