Dermatology specialists across Spain have been involved in a 60 patient review of therapies for the condition Folliculitis Decalvans
This is a rare form of hair loss
which tends to affect young men and women, and also leads to perifollicular papules, crusts and pustules on the vertex (top of the scalp).
It is caused by neutrophilic scarring and belongs to the group of conditions known as primary Cicatricial Alopecia
. It is also sometimes known as 'tufted alopecia'.
This is the latest review of a number being carried out in Spain, as researchers aim to find out more about the issue, including trying to establish best practice for both diagnosing and treating FD.
The latest review, which was published in May 2018 in the Journal of American Academy of Dermatology (ref: DOI:10.1016/j.jaad.2018.05.1240) investigates the efficacy of therapies and treatments used for Follicular Decalvans.
An 82-patient, multi-centre review of Folliculitis Decalvans also took place in 2015 ( ref: DOI:10.1111/jdv.12993), with many of the same doctors involved in this new research who are acquiring highly specialist knowledge in this area.
Of the 52 men and 30 women studied, a family history of FD was present in only three of the men. The test participants had a mean age of 35 years and researchers concluded from the data collected that severed FD could be associated with the condition's early onset, meaning before 25 years of age. Pustules located within the bald patches caused by FD were also found to be indicative of the condition being severe.
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.
Tetracyclines and the combination of clindamycin and rifampicin were found to be the most useful treatments in this research. The 2018 findings were from a review with long-term follow-up, however, so whether this is still the case in the new observations will be interesting to see once the research paper is made public.
Quality of life
In 2017, the University of Alaca in Madrid undertook the first recorded clinical study of the condition's psychological effects on those affected (ref: DOI:10.1159/000478053). At least one of the study authors - Dr. A. R. Rodrigues-Barata of the Dermatology Department at Ramon y Cajal University Hospital in Madrid - was also involved in the 2015 study and the latest 2018 treatment review. The team discovered that - perhaps unsurprisingly
, as this can often be the case for people experiencing any type of hair loss condition
- it had a 'considerable impact'.
"Interestingly, almost half of the patients considered that their alopecia was related to a poor medical care in their past," the researchers noted in their conclusion.
does not offer treatment, Folliculitis Devalvans (FD) can sometimes be managed through courses prescribed by the patient's doctor or dermatologist. Anyone who suspects they may have Folliculitus should speak to their GP first as they should then be able to refer them on to the necessary medical care providers to help them manage both the physical and mental aspects of their condition.