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

In 2019, a case study was conducted on a 37-year-old African American man with a history of androgenic alopecia and acne keloidalis nuchae, who was diagnosed with folliculitis decalvans, a chronic disease causing severe hair loss and postinflammatory hyperpigmentation. The disease, which is not fully understood, likely involves an inflammatory response to Staphylococcus aureus. The patient was treated with oral antibiotics, reducing inflammation and bacterial load. The study emphasized the importance of early recognition and treatment to limit irreversible hair loss. Various treatments were mentioned, but their efficacy varied or they were used in limited cases. Surgical hair transplants were discouraged unless the patient had been disease-free for several years. Long-term management involved tapering oral antibiotics to the lowest dose that maintains remission and avoiding caps and wigs, which can harbor Staphylococcus aureus.