Treatment of folliculitis decalvans with tacrolimus ointment

Abstract

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.

Staphylococcus aureus and chronic folliculocentric pustuloses of the scalp - cause or association?

“…SF, FD and TF describe a spectrum of CFPS with varying degrees of scarring. The exact aetiology is unknown but it has been suggested to be mediated by SA . Yet, SA was isolated in only 41·7% of our cohort.…”

“…The suggestion that SA plays a major role in the pathogenesis of CFPS is supported by reports showing microbiological detection and effectiveness of anti‐SA antibiotics . However, it is recognized that increasing rates of resistance to antibiotics are associated with injudicious prescribing and a major call for antibiotic stewardship is underway in healthcare organizations such as the National Health Service .…”

Folliculitis decalvans: a multicentre review of 82 patients

“…The goal of any therapy is the arrest of inflammation and further hair loss. Case reports have described the use of multiple therapeutic agents such as systemic antibiotics and antifungals, dapsone, photodynamic therapy or topical tacrolimus . Recently, isolated cases responding to adalimumab, infliximab or Nd‐YAG laser have been published.…”

Epidermal psoriasiform hyperplasia, an unrecognized sign of folliculitis decalvans: A histological study of 26 patients

“…A small number of previous publications mentioned hyperplasia of the epidermis in the histological descriptions of FD. Others have provided a histological picture where it is present but not described . Often clinically visible, the epidermal hyperplasia of FD was studied using dermoscopy by Rakowska et al who described a characteristic “starburst pattern,” which was observable in 66% of cases in a series of 9 patients.…”