Abstract
Folliculitis decalvans, first described by Quinquaud in 1888, is the most common form of the neutrophilic primary cicatricial alopecia. Folliculitis decalvans comprise 2.8% of all cases of hair loss and 10.7–11.2% of all cases of cicatricial alopecia. The etiology of the disease remains unclear. It may be a complex combination of a bacterial infection, a hypersensitivity reaction to “superantigens,” and a defect in host cell-mediated immunity regulation. Folliculitis decalvans mainly occurs in young and middle-aged adults; there is a male predominance. The most common trichoscopic finding of folliculitis decalvans is tufted hairs. Other trichoscopic features of active folliculitis decalvans are yellowish tubular scaling, follicular pustules, and yellow discharge. The differential diagnosis includes bacterial folliculitis, tinea capitis, dissecting cellulitis, lichen planopilaris, central centrifugal cicatricial alopecia, and erosive pustular dermatosis of the scalp. Folliculitis decalvans require protracted and often repeated treatment. First-line treatment usually consists of tetracyclines.
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