Diagnostic Delay, Comorbid Hidradenitis Suppurativa and the Prognostic Value of Bacterial Culture in Folliculitis Decalvans: A Cohort Study

    Anna Lyakhovitsky, Oz Segal, Eran Galili, Curtis Thompson, Ido Tzanani, Alon Scope, Sharon Baum, Aviv Barzilai
    TLDR Educating dermatologists and screening for related conditions are crucial for treating folliculitis decalvans effectively.
    This cohort study of 192 patients with folliculitis decalvans (FD) at the Haim Sheba Medical Center reveals a significant diagnostic delay averaging 22.2 months and a male predominance (91.7%). Common comorbidities include cystic acne and hidradenitis suppurativa (HS), with HS significantly more prevalent in severe FD cases. Positive bacterial cultures, particularly with S. aureus, are associated with more severe disease and are negative predictors for complete remission (CR). The study emphasizes the importance of early diagnosis, comprehensive treatment, and the role of bacterial cultures in predicting treatment outcomes. Despite various treatment options, FD remains resistant to therapy, highlighting the need for further research into effective management strategies.
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