Retrospective Review of Folliculitis Decalvans in 23 Patients with Course and Treatment Analysis of Long-standing Cases.

BACKGROUND: To date, there is no standard treatment of folliculitis decalvans (FD), a rare type of cicatricial alopecia. OBJECTIVE AND METHODS: The records of 23 patients with FD (1998-2012) were retrospectively analyzed, with added data review on the course and treatment of long-standing cases. RESULTS: Initial management consisted mostly of intralesional triamcinolone acetonide, clobetasol lotion, and either cephalexin, minocycline, doxycycline, or tetracycline. Alternatives consisted of rifampicin, clindamycin, ciprofloxacin, and isotretinoin. Remission was achieved in weeks to months in more than half of the cases, with low occurrence of relapse. The poor responders had a protracted course of temporary improvement and multiple relapses. CONCLUSION: The majority of patients showed improvement and subsequent remission with oral antibiotics. In some patients, it took years of slow taper before the antibiotic could be discontinued. Only a few patients had recalcitrant disease, with minimal response to their initial and alternative medications.

Retrospective Review of Folliculitis Decalvans in 23 Patients with Course and Treatment Analysis of Long-standing Cases.

BACKGROUND: To date, there is no standard treatment of folliculitis decalvans (FD), a rare type of cicatricial alopecia. OBJECTIVE AND METHODS: The records of 23 patients with FD (1998-2012) were retrospectively analyzed, with added data review on the course and treatment of long-standing cases. RESULTS: Initial management consisted mostly of intralesional triamcinolone acetonide, clobetasol lotion, and either cephalexin, minocycline, doxycycline, or tetracycline. Alternatives consisted of rifampicin, clindamycin, ciprofloxacin, and isotretinoin. Remission was achieved in weeks to months in more than half of the cases, with low occurrence of relapse. The poor responders had a protracted course of temporary improvement and multiple relapses. CONCLUSION: The majority of patients showed improvement and subsequent remission with oral antibiotics. In some patients, it took years of slow taper before the antibiotic could be discontinued. Only a few patients had recalcitrant disease, with minimal response to their initial and alternative medications.

Pattern hair loss in men: diagnosis and medical treatment.

Androgenetic alopecia is a common cause of hair loss in both men and women. The exact pathogenesis of androgenetic alopecia is not well understood. As the name implies, the role of androgens and genetic susceptibility predisposes to pattern hair loss due to gradual conversion of terminal hair into vellus hair. Male and female pattern hair loss are clinically distinct entities but histologically indistinguishable. The role of sex hormones in females is less understood. This article discusses current understanding of the etiopathogenesis of hair loss in men, diagnostic tests available, and its medical management.

Hair transplantation update: procedural techniques, innovations, and applications.

The advances in hair transplantation, particularly the advent of follicular unit transplantation, have greatly elevated the outcome of this procedure. Various modifications to the basic technique as well as innovations focused on the different aspects of the hair transplantation procedure have further enhanced this type of hair restoration surgery. In addition, there is ongoing expansion of the indications and applications of this procedure beyond the usual male pattern hair loss.

Wigs and hairpieces: evaluating dermatologic issues.

Hair is an important feature of self-image, and hair loss can have a devastating impact on a person's pychological well-being. In recent years, there has been an explosion of research in the understanding of various hair disorders, but unfortunately there has not been a major breakthrough and not much has changed in terms of therapeutic options available to patients with extensive hair loss. As professionals, we need to understand the social significance of hair in relation to a person's outward presentation and social interactions. We must minimize the distress alopecia can cause by providing up-to-date information to enable them to prepare for and minimize the psychological consequences of hair loss.

Recipient area folliculitis after follicular-unit transplantation: characterization of clinical features and analysis of associated factors.

BACKGROUND: Postoperative recipient-area folliculitis may be a cause of less or delayed growth of transplanted hair and an obvious cause of distress to the patient. No study has been done to elaborate on its clinical features and assess possible factors that may correlate with its occurrence. OBJECTIVE: To study the clinical features and possible factors that may be associated with the development of recipient-area folliculitis after follicular-unit transplantation (FUT). METHODS: Retrospective analysis of 27 patients who developed folliculitis after FUT and 28 patients without such complication. RESULTS: Lesion onset ranged from 2 days to 6 months after FUT (mean 1.44 months). Lesions were mostly pustules that resolved without sequela. Statistical analysis showed that, in terms of patient characteristics (e.g., hair features, scalp condition) and the number of grafts transplanted, there was no statistically significant difference in assessed parameters between those with and without folliculitis (p<.05). CONCLUSION: Main clinical features of postoperative folliculitis consist mostly of few to moderate self-limited pustules. In this study, regardless of management, lesions healed without scarring and without affecting graft growth. Neither patient characteristics nor number of grafts transplanted was associated with this complication.