Department of Dermatology, Sheba Medical Center, Tel-Hashomer, Ramat-Gan, Israel.
CTA Pathology, Portland, USA.
J Dtsch Dermatol Ges. 2023 Dec;21(12):1469-1477. doi: 10.1111/ddg.15202. Epub 2023 Oct 24.
Folliculitis decalvans (FD) is a type of primary neutrophilic cicatricial alopecia often leading to irreversible hair loss. Data on its epidemiology, clinical features, outcomes, and prognostic factors are limited.
To evaluate a cohort of patients with FD and identify characteristics of severe disease and prognostic factors which impede remission.
This retrospective cohort study included 192 patients diagnosed with FD and followed for at least six months at a tertiary center between 2010 and 2020.
There was a diagnostic delay averaging 22.2 (± 29.7) months. Comorbid follicular occlusion disorders were common. Bacterial cultures were positive in 45.6% of the cases, with Staphylococcus (S.) aureus being the most common pathogen. Severe disease was associated with comorbid hidradenitis suppurativa and a positive bacterial culture, particularly S. aureus. 50.7% of patients experienced complete remission: 32% within the first six months of treatment and 18.7% later during follow-up. Relapses were frequent. Negative prognostic factors for achieving remission included younger age and a positive bacterial culture.
There is a need for the education of dermatologists to reduce the diagnostic delay. Screening FD patients for comorbid hidradenitis suppurativa and obtaining bacterial cultures is important for treatment planning.
滤泡性脱发（FD）是一种原发性中性瘢痕性脱发，常导致不可逆的脱发。关于其流行病学、临床特征、结局和预后因素的数据有限。
评估一组 FD 患者，确定疾病严重程度的特征和阻碍缓解的预后因素。
这是一项回顾性队列研究，纳入了 2010 年至 2020 年在一家三级中心接受至少 6 个月随访的 192 例 FD 患者。
平均诊断延迟 22.2（±29.7）个月。常见合并的滤泡闭锁性疾病。45.6%的病例细菌培养阳性，最常见的病原体是金黄色葡萄球菌（S. aureus）。严重疾病与合并的化脓性汗腺炎和阳性细菌培养有关，特别是金黄色葡萄球菌。50.7%的患者完全缓解：32%在治疗的前 6 个月内，18.7%在随访期间。复发很常见。对实现缓解的负性预后因素包括年龄较小和细菌培养阳性。
需要对皮肤科医生进行教育，以减少诊断延迟。对 FD 患者进行化脓性汗腺炎合并症筛查和进行细菌培养对治疗计划很重要。
