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

September 2023 in “ Clinical, cosmetic and investigational dermatology ”

Sanusi Umar, Ade Waterman, Donna Ton, Paul Shitabata

Folliculitis decalvans scarring alopecia surgical excision second-intention healing guarded high-tension sutures skin grafts FD scarring hair loss surgery healing by secondary intention high-tension stitches skin transplants

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

In a novel approach to treating Folliculitis decalvans (FD), a scarring alopecia, five patients (one woman and four men) underwent surgical excision of lesions followed by second-intention healing with the aid of guarded high-tension sutures. This method resulted in a significant reduction in wound size, with a 47–83% contraction of the maximum wound diameters. Three patients' wounds healed entirely by second-intention, while two required minor skin grafts for complete closure. Importantly, there was no disease recurrence observed in any of the patients during a follow-up period of 10–24 months. This study presents the first successful report of surgical treatment for FD, suggesting that this technique may offer a promising long-term remission for patients with this condition.

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