Laura Miguel-Gómez1, Ana R Rodrigues-Barata2, Ana Molina-Ruiz3, Antonio Martorell-Calatayud4, Pablo Fernández-Crehuet5, Ramón Grimalt6, Didac Barco7, Salvador Arias-Santiago8, Cristina Serrano-Falcón9, Francisco M Camacho10, David Saceda-Corralo2, Pedro Jaén-Olasolo2, Sergio Vañó-Galván2. 1. Dermatology Department, Ramon y Cajal University Hospital, Madrid, Spain. Electronic address: lmg_0007@hotmail.com. 2. Dermatology Department, Ramon y Cajal University Hospital, Madrid, Spain. 3. Dermatology Department, Fundación Jiménez Diaz Hospital, Madrid, Spain. 4. Dermatology Department, Manises Hospital Valencia, Valencia, Spain. 5. Dermatology Department, Reina Sofía Hospital, Cordoba, Spain. 6. Dermatology Department, Universitat Internacional de Catalunya, Barcelona, Spain. 7. Dermatology Department, DermAndTek Clinic, Andorra. 8. Dermatology Department, Complejo Universitario Hospital, Granada, Spain. 9. Dermatology Department, La Inmaculada Hospital, Granada, Spain. 10. Dermatology Department, Virgen Macarena Hospital, Sevilla, Spain.
Abstract
BACKGROUND: Folliculitis decalvans (FD) is a rare neutrophilic cicatricial alopecia that poses a therapeutic challenge. OBJECTIVES: To describe the therapeutic response in a large number of cases of FD with long-term follow-up and analyze potential prognostic factors associated with severity of form and with a better therapeutic response. METHODS: This multicenter prospective study included patients with FD who had a minimum of 5 years of follow-up. Severity was assessed by the maximum diameter of the cicatricial area. Therapeutic response was evaluated according to stabilization of the size of the cicatricial areas and the improvement in clinical symptoms. RESULTS: A total of 60 patients (37 men [61.7%] and 23 women [38.3%]) with a mean age of 40 years were included. Earlier age of onset (P = .01) was statistically associated with severity of form. Treatment with rifampicin and clindamycin, tetracyclines, and intralesional steroids was the most effective. No statistically significant prognostic factors predicting a better therapeutic response were found. LIMITATIONS: Because FD is a rare disease, the main limitation was the sample size. CONCLUSIONS: An earlier age of onset was associated with the severe form of the disease. The proposed specific therapeutic protocol can be a very useful tool in clinical dermatologic practice.
BACKGROUND:Folliculitis decalvans (FD) is a rare neutrophilic cicatricial alopecia that poses a therapeutic challenge. OBJECTIVES: To describe the therapeutic response in a large number of cases of FD with long-term follow-up and analyze potential prognostic factors associated with severity of form and with a better therapeutic response. METHODS: This multicenter prospective study included patients with FD who had a minimum of 5 years of follow-up. Severity was assessed by the maximum diameter of the cicatricial area. Therapeutic response was evaluated according to stabilization of the size of the cicatricial areas and the improvement in clinical symptoms. RESULTS: A total of 60 patients (37 men [61.7%] and 23 women [38.3%]) with a mean age of 40 years were included. Earlier age of onset (P = .01) was statistically associated with severity of form. Treatment with rifampicin and clindamycin, tetracyclines, and intralesional steroids was the most effective. No statistically significant prognostic factors predicting a better therapeutic response were found. LIMITATIONS: Because FD is a rare disease, the main limitation was the sample size. CONCLUSIONS: An earlier age of onset was associated with the severe form of the disease. The proposed specific therapeutic protocol can be a very useful tool in clinical dermatologic practice.