Clinical Characterization and Treatment Response of Folliculitis Decalvans Lichen Planopilaris Phenotypic Spectrum: A Retrospective Series of 31 Patients

The study examined 31 patients (20 females) with folliculitis decalvans and lichen planopilaris phenotypic spectrum, a type of cicatricial alopecia. The most common symptom was an isolated plaque of alopecia (61.3%) in the vertex, with trichoscopy showing hair tufting with perifollicular white scaling in all cases. The duration of the condition was linked to large plaques (grade III) of alopecia (p = 0.026). It took an average of 5.2 years to transition from the classic presentation of folliculitis decalvans to the phenotypic spectrum. Topical steroids (80.6%), intralesional steroids (64.5%), and topical antibiotics (32.3%) were the most used treatments. Nine clinical relapses occurred after an average of 18 months. The study concluded that this type of alopecia is likely underdiagnosed and treatment with anti-inflammatory drugs used for lichen planopilaris may be effective.