Enigma of Folliculitis Decalvans in Two Pediatric Sisters Treated with Low-Dose Isotretinoin and Erythromycin

May 2025 in “ Medical Journal of Dr D Y Patil Vidyapeeth ”

Amogh Ratnaparkhi, Praneet Awake, Anand Bhosale, Prabodh Gaikwad, Neeta Gokhale, Aditi Shende, Vivek Dugad, Rajan Bindu, Prateek Awake, Shruti Dewang

folliculitis decalvans cicatricial alopecia isotretinoin erythromycin chronic inflammation hair follicle destruction immunomodulatory effects anti-inflammatory effects Accutane

TLDR Low-dose isotretinoin and erythromycin effectively treated hair loss in two young sisters.

This case report discusses a rare occurrence of folliculitis decalvans (FD) in two young sisters, aged 5 and 3, who were effectively treated with low-dose isotretinoin and erythromycin. FD is a type of cicatricial alopecia marked by chronic inflammation and hair follicle destruction, and it is rare in children. The sisters showed patchy hair loss but experienced significant hair regrowth and sustained remission after a 3-month treatment. The study suggests isotretinoin as a promising treatment for FD due to its immunomodulatory and anti-inflammatory effects, providing an alternative or complement to antimicrobials.

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$Refractory Folliculitis Decalvans Treatment Success with a Novel Surgical Excision Approach Using Guarded High-Tension Sutures$

research Refractory Folliculitis Decalvans Treatment Success with a Novel Surgical Excision Approach Using Guarded High-Tension Sutures

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A new surgical method using special sutures significantly reduced wound size and prevented disease return in patients with a scarring scalp condition.

research Systemic Photodynamic Therapy in Folliculitis Decalvans

14 citations, September 2017 in “Clinical and Experimental Dermatology”

Systemic photodynamic therapy can effectively treat stubborn folliculitis decalvans with few side effects.

research Oral Isotretinoin as the Most Effective Treatment in Folliculitis Decalvans: A Retrospective Comparison of Different Treatment Regimens in 28 Patients

37 citations, February 2015 in “Journal of the European Academy of Dermatology and Venereology”

Oral isotretinoin is the most effective treatment for folliculitis decalvans.

research Folliculitis Decalvans: A Multicenter Review of 82 Patients

68 citations, February 2015 in “Journal of the European Academy of Dermatology and Venereology”

Early onset and pustules indicate severe hair follicle inflammation, and while antibiotics help, the condition often worsens after treatment stops.

research Primary Cicatricial Alopecia: Diagnosis and Treatment

48 citations, May 2013 in “Canadian Medical Association Journal”

Primary cicatricial alopecia, a rare disorder causing permanent hair loss, is hard to diagnose and treat, with treatments like anti-inflammatory drugs and steroids offering varied results and no guaranteed cure. Psychological support for patients is important, and future research should aim to identify causes of the condition.

research Folliculitis Decalvans: A Rare Inflammatory Scalp Disorder

112 citations, July 2008 in “Dermatologic Therapy”

Folliculitis decalvans is a rare scalp condition causing scarring hair loss, treated with long-term antibiotics and other medications, but it often comes back and is hard to manage.

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community If You Have DUPA, PLEASE READ THIS: Everyone Should Be Scalp Biopsied

in Research 830 upvotes 10 months ago

Scalp biopsies are crucial for diagnosing hair loss conditions like Diffuse Unpatterned Alopecia (DUPA) and retrograde hair loss, as treatments like finasteride and dutasteride may not be effective if other conditions are present. Combining PPAR-GAMMA agonists with retinoids could improve treatments for conditions like Lichen Planopilaris.

community Dutasteride Isn't Working? Get a Scalp Biopsy NOW

in Finasteride/Dutasteride 19 upvotes 4 months ago

Dutasteride may not be effective for everyone due to underlying issues, suggesting scalp biopsies for further diagnosis. Users discuss using higher doses of dutasteride, topical treatments, minoxidil, and pyrilutamide for hair loss management.

community DUPA/Retrograde might not be DHT based...GET A BIOPSY QUICK or permanent Hair Loss!

in Research/Science 40 upvotes 4 months ago

DUPA and retrograde alopecia may not be solely DHT-based, and a biopsy is crucial for accurate diagnosis and treatment. Treatments mentioned include dutasteride, oral minoxidil, pioglitazone, clobetasol, calcipotriol, ketoconazole, and doxycycline, depending on the specific condition.

community The Worst Hair Loss Condition You (MAY) have: LPP

in Research/Science 43 upvotes 9 months ago

Lichen Planopilaris (LPP) is an autoimmune condition causing permanent hair loss and fibrosis, often misdiagnosed. Treatments include pioglitazone, topical corticosteroids, anti-inflammatory medication, and Jak inhibitors.

community Seb derm regrowth progress? I think? Or am I just seeing what I want to see?

in Is this regrowth? 48 upvotes 1 year ago

A person with hair loss due to seborrheic dermatitis saw improvement after treating the condition and using 5mg oral minoxidil, topical minoxidil, collagen, biotin, and vitamins. They are asking if the progress is real, and others have noted the oral minoxidil as a significant treatment.

community Dutasteride switch after 8 months made my hair worse (With picture proof)

in Research/Science 63 upvotes 5 days ago

Switching to Dutasteride worsened hair condition, causing shedding and inflammation. The user will continue Dutasteride until 18 months before possibly switching back to Finasteride, while using oral Minoxidil.

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Some hair loss disorders cause permanent loss due to scarring, and treatments like steroids don't always work well.

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A Case of Folliculitis Decalvans With Concomitant Acne Keloidalis Nuchae, Androgenic Alopecia, and Profound Postinflammatory Hyperpigmentation

research A Case of Folliculitis Decalvans With Concomitant Acne Keloidalis Nuchae, Androgenic Alopecia, and Profound Postinflammatory Hyperpigmentation

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A 37-year-old man with hair loss and skin issues was successfully treated with oral antibiotics, highlighting the need for early treatment. Long-term care includes low-dose antibiotics and avoiding caps and wigs.

research Primary Cicatricial Alopecias

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The document concludes that early diagnosis and treatment are crucial for managing rare hair loss disorders and that more research is needed to improve treatment strategies.