Treatment Of Folliculitis Decalvans Research Articles

Recalcitrant Folliculitis Decalvans Treatment Outcomes With Biologics and Small Molecule Inhibitors.

Folliculitis decalvans (FD) is a rare primary neutrophilic cicatricial alopecia that commonly displays resistance to traditional therapies and remains challenging to treat. Currently, data are lacking with recommendations for therapy-recalcitrant FD. A systematic review was conducted to analyze biologics, small molecule inhibitors, tumor necrosis factor (TNF) inhibitors, Janus kinase (JAK) inhibitors, phosphodiesterase 4 (PDE4) inhibitors, and monoclonal antibodies utilized in the treatment of recalcitrant FD.

Folliculitis decalvans: clinical and morphological characteristics (literature review)

Folliculitis decalvans is a rare disease of primary cicatricial alopecias, about 11% of all alopecias of this group. Dermatosis was first described by the French dermatologist Charles-Eugne Quinquaud in 1888 and 1889. In recent decades, the number of publications devoted to the etiopathogenesis, clinical and histological characteristics, as well as approaches to the treatment of folliculitis decalvans has increased.
 The article presents the results of data analysis on the databases Scopus, Web of Science, MedLine, The Cochrane Library, EMBASE, Global Health, CyberLeninka, RSCI.
 The etiopathogenesis of the disease is still unknown. The role of seborrhea and skin colonization by Staphylococcus aureus, as well as impaired local immune response and the presence of a genetic predisposition, have previously been discussed. Folliculitis decalvans is now thought to be a result of persistent disruption of the skin barrier that predisposes to subepidermal invasion by opportunistic microorganisms, including Staphylococcus aureus. Clinical, dermatoscopic (trichoscopic) and histological characteristics of dermatosis are being specified. Its characteristic clinical features are a persistent progressive course, the formation of alopecia foci with a rich red edge, pustules and crusts along the periphery of the alopecia foci, polytrichia and the formation of a dense scar that rises above the surrounding skin. Dermatoscopic characteristics depend on the intensity of the inflammatory process. Specific trichoscopic signs of the disease include follicular pustules, yellow tubular desquamation, yellow crusts, perifollicular erythema, perifollicular hemorrhages, and fine tortuous vessels. Depending on the number of these signs, the degree of inflammation is determined. Histological features of the disease include a massive perifollicular infiltrate, the formation of gaps between the epithelium of the follicles and the surrounding stroma, and in the final stages of the process ― fibrous tracts, diffuse fibrosis in the dermis.
 The treatment of folliculitis decalvans are antibacterial drugs, it is also possible to treat with courses of topical corticosteroids, antiseptic solutions.
 We assume that the systematization of information about the etiopathogenesis and approaches to the diagnosis and treatment of folliculitis decalvans will improve the diagnosis among other primary cicatricial alopecia and the choice of the tactics of treating folliculitis decalvans.

Autistic-undisciplined thinking in the practice of medical trichology

Medical trichology is the branch of dermatology that deals with the scientific study of the hair and scalp in health and disease. As any discipline, the practice of medical trichology is not immune to malpractice, either deliberately or carelessly. In his publication “Autistic Undisciplined Thinking in Medicine and How to Overcome It,” Swiss psychiatrist Eugen Bleuler describes yet another form of malpractice in medicine reflecting autistic-undisciplined thinking. Autism is not limited to psychopathology, but inherent to the thinking of man throughout history in his drive for knowledge, with thousands of theories lacking any basis in reality. Bleuler recognized the drive character of autistic thinking and how it leads to conclusions that are unshakable because they are determined by, and fulfill, emotional needs, rather than rational argumentation. Even with correct questions, the complexity and incalculability of some problems are often so great that it cannot do justice to realistic thinking and the boundaries between inadequately substantiated hypothesis and autistic sham explanation disappear. Statistics, careful research design, and the attempt to impose stringent methods on our thinking are to be commended. The habituation of the public to useless medicine, to misconceptions, is not hygiene, but negligent endangerment. It has created an industry that largely lives on the autistic thinking of patients and doctors and because it is prosperous, makes propaganda among lay people as well as among doctors that necessarily leads to abuses. This article aims at exposing the most prevalent among abuses in trichological practice due to autistic-undisciplined thinking, specifically: iron supplementation, antiandrogenic treatment, and individualized cell-based therapy in female androgenetic alopecia, treatment of folliculitis decalvans with retinoids, and the value of nutritional therapies.

Resolution of folliculitis decalvans with medical honey

Folliculitis decalvans is a rare scarring alopecia that presents with indurated, tender pustules and papules on the vertex and occipital scalp. Although systemic antibiotics with activity against Staphylococcus species provide some symptomatic improvement, folliculitis decalvans remains a significant management challenge and often exhibits a relapsing-and-remitting course. In this report, we posit the potential utility of medical grade honey as a safe and cost-effective adjuvant therapy in the treatment of folliculitis decalvans. We describe a patient with painful, boggy scalp pustules who achieved clearance of his scalp lesions with the addition of Manuka honey. To our knowledge, this report is the first to demonstrate the clinical use of honey in the management of folliculitis decalvans and may lend support to the role of Staphylococcus in the pathogenesis of this disease.

Treatment of folliculitis decalvans with photodynamic therapy: Results in 10 patients

To the Editor: Different therapies such as doxycycline, rifampicin, isotretinoin, or intralesional corticosteroids have been used for folliculitis decalvans (FD) with poor results.1 It has been suggested that scalp colonization by Staphylococcus aureus induces an intense inflammatory reaction leading to scarring alopecia with erythema, pustules, and yellowish crusts around hair follicles.2,3 Photodynamic therapy (PDT) has immunomodulatory, antiinflammatory, and bactericidal activity4 due to its phototoxic effects, preventing the proliferation of S aureus.

The challenge in the treatment of folliculitis decalvans: 12months of clinical follow-up after using fractional CO2 laser associated with PDT

The challenge in the treatment of folliculitis decalvans: 12months of clinical follow-up after using fractional CO2 laser associated with PDT

Photodynamic therapy for the treatment of folliculitis decalvans

Folliculitis decalvans is a chronic form of deep folliculitis that occurs on the scalp as patches of scarring alopecia at the expanding margins of which are follicular pustules. Treatment of folliculitis decalvans is extremely difficult with a resultant poor prognosis. Photodynamic therapy has been reported to be effective in disorders as acne or folliculitis. We report one patient with folliculitis decalvans who was successfully treated with photodynamic therapy.

Treatment of folliculitis decalvans with tacrolimus ointment

Folliculitis decalvans is an embarrassing and challenging disease with no established treatment guidelines. In this paper, we described four patients with this disease treated successfully with Tacrolimus ointment. All of them showed significant control of the condition, stopping inflammatory lesions and progression of the disease, although weak transitory outbreaks of inflammatory lesions were observed in some cases. Alopecia and tufted hairs remained unchanged. The discontinuation of the therapy produced rapid relapses in all cases. Close monitoring of these patients is recommended due to the potential risk of malignant transformation of the disease.

Rifampin in the treatment of folliculitis decalvans

The cause of folliculitis decalvans is still debated. Staphylococcus aureus is often cultured from the lesions, but it is not the sole factor involved in the pathogenesis of the disease. Folliculitis decalvans is known for its resistance to treatment, resulting in an unfavourable prognosis. We report a case that resolved after two cycles of therapy with rifampin. We discuss the mechansims of action of rifampin and the pathogenesis of folliculitis decalvans.