Folliculitis Decalvans

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Folliculitis Decalvans
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What is Folliculitis decalvans?

• Folliculitis decalvans is a progressive disorder
  of the scalp that is characterized by
  inflammation and scarring. It causes inflammation
  of the hair follicles which makes the follicles
  accompanied by redness and swelling.This
  ultimately destroys the follicles and results in
  permanent hair loss. The chronic inflammation
  further leads to scarring and folliculitis
  decalvans progresses to cicatricial alopecia
  (baldness with scarring).This condition affects
  both men and women and can occur at any time from
  adolescent to adult life. However it has been
  observed that men are more likely to have an
  early onset from adolescence whereas women tend
  to develop it much later in their life after 40
  years of age.

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What causes Folliculitis decalvans?

• Still the exact cause of folliculitis decalvans
  is not known. But the organism staphylococcus
  aureus seems to play a role in the pathogenesis
  of the disease as it is found in the pustular
  lesions.Staphylococcus aureus constitutes the
  normal flora of the skin. It is debatable if the
  bacteria are simply colonizing the infection or
  it is primarily responsible for inducing an
  immune response.Another causative possibility
  suspected is a strong abnormal inflammatory
  response to the pathogen. Also, familial
  investigations have led to the conclusion that
  there is a certain genetic predisposition linked
  to this disorder.

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What are the signs and symptoms of folliculitis
decalvans?

• The main feature of folliculitis decalvans is
  follicular scarring and pustules, which may be
  purulent. Patients also report itching, pain and
  a burning sensation.In many cases, crusting
  around the pustules and spontaneous bleeding is
  also observed. Folliculitis decalvans
  predominantly starts at the occipital and vertex
  region and is restricted to a few patches or
  advances to cicatricial alopecia with many oval
  patches of scars.Tufted folliculitis is a
  common feature of folliculitis decalvans. When
  various hairs sprout out of a single follicle, it
  is called tufting.These tufts of hair are shed
  and the follicles are eventually destroyed thus
  leaving a scar. However, many people do not
  encounter and specific symptoms at all.

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What is the treatment of folliculitis decalvans?

• The primary cause of folliculitis decalvans is
  unknown. This makes it difficult to find the
  right treatment.However, the bacteria
  staphylococcus aureus along with poor immunity
  and an inflammatory response leads to the
  development of this condition.The treatment
  primarily aims at eliminating staphylococcus
  aureus. There is no specific cure available to
  treat folliculitis decalvans but the disease can
  be restrained to smaller patches by antibiotic
  therapy.It includes topical antiseptics,
  topical and oral antibiotics, for example
  rifampicin along with clindamycin has shown to be
  effective.Topical antibiotics accompanied by
  intranasal therapy have shown positive results.
  Corticosteroids provide symptomatic relief and
  subside inflammation. Oral therapy including
  dapsone and zinc sulphate has also shown positive
  effects to an extent.

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