Folliculitis Decalvans: Why Is There No Established Treatment?

Folliculitis decalvans (FD) was a challenging condition to treat due to its poor response to existing therapies and the lack of standardized treatment guidelines. Despite various treatments like antibiotics, corticosteroids, and tacrolimus ointment (TO), results were often nonreproducible. The disease's rarity, non-life-threatening nature, and poorly understood etiology contributed to the difficulty in establishing effective treatments. The variability in clinical presentation and the inclusion of questionable cases in studies further complicated diagnosis and treatment. While TO showed promise in controlling symptoms and preventing disease progression in some cases, it did not alter the chronic course of FD, necessitating long-term treatment and close monitoring for potential malignant transformation. More rigorous, large-scale studies were needed to advance understanding and treatment of FD.