Updates in Therapeutics for Folliculitis Decalvans: A Systematic Review with Evidence-Based Analysis

August 2018 in “ Journal of the American Academy of Dermatology ”

Pooja H. Rambhia, Rosalynn R.Z. Conic, Aizuri Murad, Natasha Atanaskova-Mesinkovska, Melissa Piliang, Wilma F. Bergfeld

folliculitis decalvans clindamycin rifampicin isotretinoin photodynamic therapy hyperlipidemia Accutane PDT

TLDR Clindamycin and rifampicin are the most effective treatments for folliculitis decalvans, but more research is needed.

The systematic review on therapeutics for folliculitis decalvans (FD) analyzed 20 studies involving 282 patients and highlighted various treatment options, including antibiotics, corticosteroids, and biologics. Clindamycin and rifampicin showed the longest remission (7.2 months) in a multicenter study, but results varied, and relapses were common. Other treatments like doxycycline, azithromycin, and isotretinoin had mixed efficacy and side effects. Newer therapies like red light photodynamic therapy showed promise but had low evidence levels. The review concluded that more rigorous, large-scale randomized controlled trials were needed to establish the most effective treatments and develop standardized protocols.

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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”

Some treatments for folliculitis decalvans work well, with tetracyclines and a mix of rifampicin and clindamycin being most effective.

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

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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”

Oral isotretinoin is the most effective treatment for folliculitis decalvans.

research Folliculitis Decalvans: A Multicenter Review of 82 Patients

68 citations , February 2015 in “Journal of the European Academy of Dermatology and Venereology”

Early onset and pustules indicate severe hair follicle inflammation, and while antibiotics help, the condition often worsens after treatment stops.

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”

Most patients improved with oral antibiotics, but some needed long-term treatment or had minimal response.

research Folliculitis Decalvans Including Tufted Folliculitis: Clinical, Histological, and Therapeutic Findings

226 citations , February 1999 in “British Journal of Dermatology”

Folliculitis decalvans and tufted folliculitis are related, and a new treatment with rifampicin and clindamycin is effective.

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