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There are many different kinds of folliculitis that can afflict people of all ages
and from all walks of life. Some are easier than others to treat, but one of the
most difficult forms of folliculitis to treat is also one of the rarest and most
troubling; it is called Folliculitis Decalvans.
Folliculitis Decalvans is a rare and disfiguring form of folliculitis. Very little is known about its cause, although medical research has shown that patients who suffer from this rare condition often have Staphylococcus aureus bacteria present on their scalp and in their hair follicles, but it is not clear that the bacteria has anything to do with the condition. Where most types of folliculitis cause red bumps and infections, Folliculitis Decalvans lesions lead to permanent hair loss and disfiguring scars for those who fall victim to it. Though most cases show up on the scalp, the condition can appear anywhere on the body that has hair, including arms, legs, eyebrows and the pubic area.
Patients who present with Folliculitis Decalvans often have large patches of skin that have lost all of their hair, and the area is usually badly scarred. Inflamed pustules and lesions within these hairless areas often have single follicles from which several hairs are growing. This phenomena is referred to as tufted folliculitis, and it is generally the result of serious damage being done to a series of hair follicles in a single area, with several hairs ending up grouping and growing out of the single remaining undamaged follicle. The lesions often have areas of scaly grey or yellow skin surrounding them, and the surrounding area is often described as having a variety of painful looking scales, holes, eruptions and erosions. Bleeding is often reported by the patient, as well as itchiness, a sensation of burning and pain. They also report that follicles often leak a fluid that is filled with pus. As the condition spreads, alopecia, or permanent hair loss sets in and the patches generally get larger. The condition is extremely resistant to treatment.
Although very little is known about what causes this condition, the presence of the staph infection as well as indications that the disease may run in families has pointed to the possibility that the condition may be genetically related, and may represent an inability to fight off the staph infection, particular in areas where there are hair follicles and sebaceous glands.
Because this condition leads to such a dramatic change in the patient's appearance, and because people's sense of self-
Excellent and meticulous hygiene must be practiced, and head covering may often need
to be replaced for fear of reinfection. As for medication, the most effective treatment
that has been found has been a combination of Rifampin (a medication that is usually
used in the treatment of tuberculosis) and Clindamycin, a powerful antibiotic. Unfortunately,
though this combination is usually effective, it is also known to cause serious side
effects, including problems of hepatitis and colitis. Though other antibiotics have
been successful at stopping the spread of the condition, studies have shown that
as soon as the patient discontinues taking these antibiotics the condition returns.
In order to prevent this kind of relapse, patients may need to go on an prophylactic,
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