Folliculitis Decalvans: A Rare Inflammatory Scalp Disorder
July 2008
in “
Dermatologic Therapy
”
TLDR 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.
The 2008 document describes Folliculitis decalvans (FD) as a rare, inflammatory scalp disorder that leads to scarring hair loss, primarily affecting middle-aged adults with a higher incidence in males and African Americans. It is characterized by follicular pustules, erythema, and tufting, with Staphylococcus aureus and a deficient immune response being key factors in its pathogenesis. Diagnosis requires a detailed history, scalp examination, bacterial cultures, and a skin biopsy. Treatment aims to control S. aureus and inflammation, using long-term oral antibiotics like rifampin and clindamycin, topical antibiotics, antiseptics, and corticosteroids, with other options like isotretinoin, dapsone, oral zinc sulfate, and surgery being considered with caution. The document stresses the challenges in treating FD, the likelihood of relapse, the need for long-term management, and the importance of patient education regarding the chronic nature of the disease and potential side effects of treatments.
