Friday, May 05, 2006

Folliculitis and Hair Loss

The patient is a 30 year-old man with a 2 year history of folliculitis and mild hair loss. He has erythematous papules and a few pustules scattered over the scalp. Cultures have been negative. Biopsy showed only inflammation c/w folloculitis. Minocycline has been of marginal help, but process recurrs when he stops. He has an occasional papule on his cheeks but no signs of rosacea. His hair is globally thin.

Question: Is this folliculitis decalvans? Would isotretinoin be worth trying? He is also interested in hair transplantation.



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6 comments:

  1. AnonymousMay 05, 2006

    Very nice case to discuss.I think the data should answer the following questions:

    1.Is the problem confined to scalp only and if is it symptomatic?
    2.The scalp looks erythematous.Is there a background of seb.dermatitis ?
    3.Hair loss looks more than mild.If it is not scarring ,do the patient has family history of androgenetic alopecia ?

    It is not uncommon to face such cases especially in a young people(both white and Black races).Examination revealed healthy scalp apart from scattered pruritic excoriated papules and pustules and not necessarly associated with alopecia.In the majority no lacal or systemic pathology could be elicited.Althought they didn't admit with psychological imbalance but I feel it is suspecious.They didn't respond enough to oral antihistamines or different types of topical soothings,antipruritics or medicated shampoos.Many cases showed good response to antidepressants suggesting to be part of psychocutaneous entities.

    ReplyDelete
  2. ksharquieMay 06, 2006

    This case has psychological element whether a primary or on top of seboeric dermatitis which is in a form of neurotic excoriation.There is no tufting of hair which is against scarring folliculitis.Please reasses the case again
    khalifa sharquie

    ReplyDelete
  3. AnonymousMay 09, 2006

    Yes, This is folliculitis decalvans.
    No, in my estimation isotretinoin would not be worthy.
    Treat it with dapsone and he'll be happy.
    Omid
    PS:don't forget to be sure about g6pd sufficiency before starting dapsone.

    ReplyDelete
  4. AnonymousMay 19, 2006

    I don't see enuf scarring to call it folliculitis decalvans;however I have treated similar cases with Isotretinoin & have had good success.

    ReplyDelete
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    ReplyDelete
  6. P. RocerinMarch 27, 2010

    What do you do about it? First of all try to determine if it's related to any current medical diagnosis you have right now. Then take a look at any medications you may be taking in case it's temporary and related to medications, medicines or drugs.

    ReplyDelete

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