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

Studysummary This case series reports successful treatment of refractory folliculitis decalvans using surgical excision with second-intention healing and guarded high-tension suturing, resulting in long-term remission without recurrence over a 10–24 month follow-up period. Our plain-language summary of this paper — not a Tressless recommendation.

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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research Unveiling a Shared Precursor Condition for Acne Keloidalis Nuchae and Primary Cicatricial Alopecias

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research Lichen Planopilaris Responsive to a Novel Phytoactive Botanical Treatment: A Case Series

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research Selection Criteria and Techniques for Improved Cosmesis and Predictable Outcomes in Laser Hair Removal Treatment of Acne Keloidalis Nuchae

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This report discusses laser hair removal for acne keloidalis nuchae, noting generally favorable outcomes but variability in lesion responsiveness and a need for standardized assessment criteria; it reports no new results.

research Frequency of the Types of Alopecia at Twenty-Two Specialist Hair Clinics: A Multicenter Study

56 citations , January 2019 in “Skin appendage disorders”

In this multicenter study, androgenetic alopecia was the most common type of alopecia among both men and women attending specialty hair clinics on four continents.

Folliculitis Decalvans: Effectiveness of Therapies and Prognostic Factors in a Multicenter Series of 60 Patients with Long-Term Follow-Up

research Folliculitis Decalvans: Effectiveness of Therapies and Prognostic Factors in a Multicenter Series of 60 Patients with Long-Term Follow-Up

41 citations , June 2018 in “Journal of The American Academy of Dermatology”

This study examined the therapeutic response to folliculitis decalvans treatments among 60 patients and found that earlier disease onset was linked to more severe cases, while a combination of rifampicin, clindamycin, tetracyclines, and intralesional steroids was most effective in controlling symptoms.

research Isotretinoin Treatment for Folliculitis Decalvans: A Retrospective Case-Series Study

23 citations , January 2018 in “International Journal of Dermatology”

In this retrospective study, oral isotretinoin monotherapy effectively achieved remission in 82% of patients with folliculitis decalvans, with those receiving ≥0.4 mg/kg/day for ≥3 months experiencing better outcomes and less frequent relapse.

research Treatment of Acne Keloidalis Nuchae: A Systematic Review of the Literature

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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”

This study found that among patients with folliculitis decalvans, treatment with isotretinoin achieved the highest rate of stable remission compared to antibiotic regimens like clindamycin and rifampicin.

research Retrospective Review of Folliculitis Decalvans in 23 Patients with Course and Treatment Analysis of Long-Standing Cases

43 citations , January 2015 in “Journal of Cutaneous Medicine and Surgery”

This study found that most patients with folliculitis decalvans showed improvement and remission with oral antibiotics, although some experienced relapses and required prolonged treatment.