Folliculitis decalvans

Folliculitis decalvans on the scalp

Folliculitis decalvans is a rare, chronic inflammatory condition of the scalp that leads to scarring hair loss. It is characterized by the destruction of hair follicles, resulting in permanent hair loss and scarring.

Pathophysiology

Folliculitis decalvans is believed to be an autoimmune disease where the body's immune system attacks the hair follicles. The exact cause is not well understood, but it is thought to involve a combination of genetic predisposition and bacterial infection, particularly with Staphylococcus aureus.

Clinical Presentation

Patients with folliculitis decalvans typically present with:

• Alopecia (hair loss)
• Pustules and papules on the scalp
• Erythema (redness)
• Crusting and scaling
• Itching and tenderness

The condition often begins with small patches of hair loss that gradually expand over time.

Diagnosis

Diagnosis of folliculitis decalvans is primarily clinical, based on the characteristic appearance of the scalp. A skin biopsy may be performed to confirm the diagnosis and rule out other causes of scarring alopecia. Bacterial cultures may be taken to identify any secondary infections.

Treatment

Treatment options for folliculitis decalvans include:

• Antibiotics to control bacterial infection
• Corticosteroids to reduce inflammation
• Immunosuppressive drugs in severe cases
• Topical treatments such as antiseptic shampoos

Management focuses on controlling symptoms and preventing further hair loss, as there is no cure for the condition.

Prognosis

Folliculitis decalvans is a chronic condition that can be difficult to manage. While treatment can help control symptoms and slow progression, the scarring and hair loss are usually permanent.

Related pages

• Alopecia areata
• Lichen planopilaris
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