*Scarring condition of the scalp causing hair loss
*Consists of Folliculitis of scalp hair follicles, which results in damage and scarring of the follicle and subsequent hair loss
Folliculitis decalvans is a scarring type of alopecia, or hair loss, which typically affects the scalp. The condition initially presents as Folliculitis (swelling, redness, pustules). This results in the follicle being destroyed, causing scarring and hair loss. The condition may be accompanied by itching in the affected area. Follicle destruction is not immediate, so affected areas may be surrounded by areas of previous hair loss, giving the affected area a tufted look. Affected areas may be limited, but in some cases the condition becomes widespread, causing large areas of alopecia and scarring.
The cause of Folliculitis decalvans is not entirely known. There are likely genetic components in many cases which cause follicular occlusion. Some cases are accompanied by a bacterial infection of the follicle, but what role this infection plays in the development of the condition is unclear.
Differential Diagnosis (Other conditions with similar appearance)
Dissecting Cellulitis of the scalp
*Diagnosis based on the characteristic appearance of the affected area
*Skin biopsy and bacterial cultures may be performed to confirm diagnosis and rule out other conditions
Folliculitis decalvans is diagnosed based on the characteristic appearance of the affected area. A skin Biopsy and bacterial cultures of lesions may be performed to confirm the diagnosis and rule out similar appearing conditions.
*Tetracyline derivatives with or without topical steroids
*Bacterial culture should be performed to rule out coexisting infection which should be treated based on sensitivities if present
Treatment of the condition typically consists of controlling symptoms through administration of various systemic medications, most often antibiotics (including Tetracycline, Rifampicin, Clindamycin, Fusidic acid, Dicloxacillin, and Ciprofloxacin). Isotretinoin has been shown to have some effectiveness in treatment. In severe cases, corticosteroids may be prescribed in conjunction with other medications.