Folliculitis Decalvans: An Uncommon Case Report with Review of Literature

January 2025 in “ International Journal of Applied and Basic Medical Research ”

Gyanendra Singh, Yashdeep Singh Pathania, Parth Goswami, Shilpi Tyagi, Tarang Patel

folliculitis decalvans scarring hair loss alopecia neutrophilic infiltration perifollicular fibrosis minocycline betamethasone

TLDR Effective treatment of folliculitis decalvans requires accurate diagnosis and more research for better therapies.

Folliculitis decalvans (FD) is a chronic inflammatory condition leading to scarring hair loss, primarily on the scalp, and is challenging to treat due to its relapsing nature and limited understanding of its pathogenesis. This case report details a 40-year-old female with FD, presenting with itchy follicular papules and alopecia on the scalp. Histopathological examination revealed neutrophilic infiltration and perifollicular fibrosis. Treatment with minocycline and betamethasone showed significant improvement. The report emphasizes the importance of distinguishing FD from similar conditions for effective management and highlights the need for further research to develop better therapies.

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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 Central Centrifugal Cicatricial Alopecia: Challenges and Solutions

37 citations , August 2016 in “Clinical, Cosmetic and Investigational Dermatology”

The document concludes that better treatments for CCCA are needed and more research is required to understand its causes related to hairstyling and genetics.

research Histopathology of Alopecia: A Clinicopathological Approach to Diagnosis

170 citations , December 2009 in “Histopathology”

The conclusion is that accurate diagnosis of different types of hair loss requires good teamwork between skin doctors and lab experts.

research Folliculitis Decalvans: A Rare Inflammatory Scalp Disorder

112 citations , July 2008 in “Dermatologic Therapy”

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.

research Frontal Fibrosing Alopecia Versus Lichen Planopilaris: A Clinicopathological Study

126 citations , April 2006 in “International Journal of Dermatology”

The conclusion is that FFA and LPP have similar scalp biopsy features, making them hard to distinguish histologically, and FFA may be a specific kind of scarring hair loss.

research Primary Cicatricial Alopecias: Clinicopathology of 112 Cases

254 citations , December 2003 in “Journal of the American Academy of Dermatology”

Accurate diagnosis and aggressive treatment are crucial to prevent permanent hair loss in cicatricial alopecia.

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community If You Have DUPA, PLEASE READ THIS: Everyone Should Be Scalp Biopsied

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Scalp biopsies are crucial for diagnosing hair loss conditions like Diffuse Unpatterned Alopecia (DUPA) and retrograde hair loss, as treatments like finasteride and dutasteride may not be effective if other conditions are present. Combining PPAR-GAMMA agonists with retinoids could improve treatments for conditions like Lichen Planopilaris.

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Increased Malassezia and Cutibacterium in the scalp microbiome are linked to higher sebum production and inflammation in androgenetic alopecia (AGA). Treatments include ciclopirox shampoo, benzoyl peroxide shampoo, clobetasol propionate, calcipotriol, minoxidil, finasteride, and dutasteride.

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Dutasteride may not be effective for everyone due to underlying issues, suggesting scalp biopsies for further diagnosis. Users discuss using higher doses of dutasteride, topical treatments, minoxidil, and pyrilutamide for hair loss management.

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Topical roflumilast is effective for reducing inflammation in various scalp conditions like seborrheic dermatitis, psoriasis, and eczema, but not proven to stop scarring alopecia. Alternatives like apremilast and Vtama are also discussed for their anti-inflammatory benefits.

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DUPA and retrograde alopecia may not be solely DHT-based, and a biopsy is crucial for accurate diagnosis and treatment. Treatments mentioned include dutasteride, oral minoxidil, pioglitazone, clobetasol, calcipotriol, ketoconazole, and doxycycline, depending on the specific condition.

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