S Vañó-Galván1, A M Molina-Ruiz2, P Fernández-Crehuet3, A R Rodrigues-Barata4, S Arias-Santiago5, C Serrano-Falcón6, A Martorell-Calatayud7, D Barco8, B Pérez1, S Serrano9, L Requena2, R Grimalt10, J Paoli11, P Jaén1, F M Camacho12. 1. Hospital Ramón y Cajal, IRYCIS, Universidad de Alcalá, Madrid, Spain. 2. Fundación Jiménez Diaz, Madrid, Spain. 3. Alto Guadalquivir de Andújar, Jaén, Spain. 4. Grupo Pedro Jaén, Madrid, Spain. 5. Unidad de Dermatología Hospital Virgen de las Nieves, Instituto de Investigaciones Biosanitarias IBS, Hospitales Universitarios de Granada/Universidad de Granada, Granada, Spain. 6. Guadix, Granada, Spain. 7. Manises, Valencia, Spain. 8. Teknon, Barcelona, Spain. 9. Universidad de Granada, Granada, Spain. 10. Universitat Internacional de Catalunya, Barcelona, Spain. 11. Sahlgrenska University Hospital, Gothenburg, Sweden. 12. Virgen Macarena, Sevilla, Spain.
Abstract
BACKGROUND: Folliculitis decalvans (FD) is a rare neutrophilic scarring alopecia that represents a therapeutic challenge for dermatologists. OBJECTIVE: To describe the epidemiology, comorbidities, clinical presentation, diagnostic findings and therapeutic options in a large series of patients with FD. METHODS: This retrospective multicentre review includes patients diagnosed with FD based on clinical and histopathologic findings. The clinical severity was determined by the maximum diameter of the largest alopecic patch (slight: <2 cm, moderate: 2-4.99 cm, severe: 5 cm or more). Response to therapy was assessed as improvement, worsening or stabilization depending on the clinical symptoms (pruritus and trichodynia), inflammatory signs (erythema, pustules and crusts) and the extension of the alopecic patch. RESULTS: Overall, 82 patients (52 males and 30 females) with a mean age of 35 years were included. No significant comorbidities were present. A family history was present in three males. Severe FD was observed in 17 patients (21%). The independent factors associated with severe FD after multivariate analysis were: onset of FD before 25 years of age and presence of pustules. Oral antibiotics (tetracyclines and the combination of clindamycin and rifampicin) improved 90% and 100% of the patients, with a mean duration of response of 4.6 and 7.2 months respectively. CONCLUSIONS: The onset of FD before 25 years of age and the presence of pustules within the alopecic patch were associated with severe FD. Tetracyclines and the combination of clindamycin and rifampicin were the most useful treatments.
BACKGROUND:Folliculitis decalvans (FD) is a rare neutrophilic scarring alopecia that represents a therapeutic challenge for dermatologists. OBJECTIVE: To describe the epidemiology, comorbidities, clinical presentation, diagnostic findings and therapeutic options in a large series of patients with FD. METHODS: This retrospective multicentre review includes patients diagnosed with FD based on clinical and histopathologic findings. The clinical severity was determined by the maximum diameter of the largest alopecic patch (slight: <2 cm, moderate: 2-4.99 cm, severe: 5 cm or more). Response to therapy was assessed as improvement, worsening or stabilization depending on the clinical symptoms (pruritus and trichodynia), inflammatory signs (erythema, pustules and crusts) and the extension of the alopecic patch. RESULTS: Overall, 82 patients (52 males and 30 females) with a mean age of 35 years were included. No significant comorbidities were present. A family history was present in three males. Severe FD was observed in 17 patients (21%). The independent factors associated with severe FD after multivariate analysis were: onset of FD before 25 years of age and presence of pustules. Oral antibiotics (tetracyclines and the combination of clindamycin and rifampicin) improved 90% and 100% of the patients, with a mean duration of response of 4.6 and 7.2 months respectively. CONCLUSIONS: The onset of FD before 25 years of age and the presence of pustules within the alopecic patch were associated with severe FD. Tetracyclines and the combination of clindamycin and rifampicin were the most useful treatments.
Authors: Cristina Pindado-Ortega; David Saceda-Corralo; Laura Miguel-Gómez; Diego Buendía-Castaño; Pablo Fernández-González; Oscar M Moreno-Arrones; Pablo Fonda-Pascual; Adrian Alegre-Sánchez; Rita Rodrigues-Barata; Sergio Vañó-Galván Journal: Skin Appendage Disord Date: 2017-07-20
Authors: Sergio Vañó-Galván; David Saceda-Corralo; Ulrike Blume-Peytavi; Jose Cucchía; Ncoza C Dlova; Maria Fernanda Reis Gavazzoni Dias; Ramon Grimalt; Daniela Guzmán-Sánchez; Matthew Harries; Anthony Ho; Susan Holmes; Jorge Larrondo; Anisa Mosam; Rui Oliveira-Soares; Giselle M Pinto; Bianca M Piraccini; Rodrigo Pirmez; Daniel De la Rosa Carrillo; Lidia Rudnicka; Jerry Shapiro; Rodney Sinclair; Antonella Tosti; Ralph M Trüeb; Annika Vogt; Mariya Miteva Journal: Skin Appendage Disord Date: 2019-04-02