title: Folliculitis decalvans: a multicentre review of 82 patients.
abstract: BACKGROUND
  Folliculitis decalvans (FD) is a rare neutrophilic scarring alopecia that represents a therapeutic challenge for dermatologists.
  
  
  OBJECTIVE
  To describe the epidemiology, comorbidities, clinical presentation, diagnostic findings and therapeutic options in a large series of patients with FD.
  
  
  METHODS
  This retrospective multicentre review includes patients diagnosed with FD based on clinical and histopathologic findings. The clinical severity was determined by the maximum diameter of the largest alopecic patch (slight: <2 cm, moderate: 2-4.99 cm, severe: 5 cm or more). Response to therapy was assessed as improvement, worsening or stabilization depending on the clinical symptoms (pruritus and trichodynia), inflammatory signs (erythema, pustules and crusts) and the extension of the alopecic patch.
  
  
  RESULTS
  Overall, 82 patients (52 males and 30 females) with a mean age of 35 years were included. No significant comorbidities were present. A family history was present in three males. 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.
  
  
  CONCLUSIONS
  The onset of FD before 25 years of age and the presence of pustules within the alopecic patch were associated with severe FD. Tetracyclines and the combination of clindamycin and rifampicin were the most useful treatments.
authors: Hospital Ramón y Cajal, IRYCIS, Universidad de Alcalá, Madrid, Spain.
authors: S
authors: S
authors: Vañó-Galván
authors: Fundación Jiménez Diaz, Madrid, Spain.
authors: A M
authors: AM
authors: Molina-Ruiz
authors: Alto Guadalquivir de Andújar, Jaén, Spain.
authors: P
authors: P
authors: Fernández-Crehuet
authors: Grupo Pedro Jaén, Madrid, Spain.
authors: A R
authors: AR
authors: Rodrigues-Barata
authors: Unidad de Dermatología Hospital Virgen de las Nieves, Instituto de Investigaciones Biosanitarias IBS, Hospitales Universitarios de Granada/Universidad de Granada, Granada, Spain.
authors: S
authors: S
authors: Arias-Santiago
authors: Guadix, Granada, Spain.
authors: C
authors: C
authors: Serrano-Falcón
authors: Manises, Valencia, Spain.
authors: A
authors: A
authors: Martorell-Calatayud
authors: Teknon, Barcelona, Spain.
authors: D
authors: D
authors: Barco
authors: Hospital Ramón y Cajal, IRYCIS, Universidad de Alcalá, Madrid, Spain.
authors: B
authors: B
authors: Pérez
authors: Universidad de Granada, Granada, Spain.
authors: S
authors: S
authors: Serrano
authors: Fundación Jiménez Diaz, Madrid, Spain.
authors: L
authors: L
authors: Requena
authors: Universitat Internacional de Catalunya, Barcelona, Spain.
authors: R
authors: R
authors: Grimalt
authors: Sahlgrenska University Hospital, Gothenburg, Sweden.
authors: J
authors: J
authors: Paoli
authors: Hospital Ramón y Cajal, IRYCIS, Universidad de Alcalá, Madrid, Spain.
authors: P
authors: P
authors: Jaén
authors: Virgen Macarena, Sevilla, Spain.
authors: F M
authors: FM
authors: Camacho
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000506:Alopecia Areata / Q000175:diagnosis / Q000453:epidemiology / Q000209:etiology*; D046169:Dermoscopy; D005260:Female; D005499:Folliculitis / Q000150:complications / Q000175:diagnosis* / Q000453:epidemiology; D006801:Humans; D015994:Incidence; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D012536:Scalp Dermatoses / Q000150:complications / Q000175:diagnosis* / Q000453:epidemiology; D012720:Severity of Illness Index; D013030:Spain / Q000453:epidemiology; D055815:Young Adult