Photodynamic Therapy as a Therapeutic Option for Folliculitis decalvans

Folliculitis decalvans is a rare chronic, neutrophilic inflammation of the scalp. Although the etiopathogenesis is not fully understood, there is a reason to believe that folliculitis decalvans reflects a misdirected immune response to scalp-associated microbes, in particular to Staphylococcus aureus. We report on a 51-year-old man who came to our clinic with painful follicular papules, pustules and crusts on the scalp that resulted in scarring and hair loss since his puberty. Topical Mometasonfuroat was used at presentation. Systemic therapies with doxycyline and 13-cis retinoic acid were only effective for a short period of time. We initiated photodyanmic therapy with methyl 5-amino-4-oxopentanoate (Metvix) and LED red light, 37 J/cm (2) . After 4 cycles, the folliculitis decalvans had almost healed entirely and hair started to grow back.