Folliculitis decalvans including tufted folliculitis: clinical, histological and therapeutic findings

In a series of 18 patients with folliculitis decalvans attending the Oxford hair clinic, eight were found to have areas of tufted folliculitis either at presentation or following. There was no difference between these two gro ups in their presentation, clinical course, growth of causative organism (S taphylococcus aureus) or investigations including histology. We suggest tha t these two entities form part of a spectrum of a single disease. We perfor med lymphocyte staining on affected scalp biopsies, including CD4: CD8 and T-cell/B-cell ratios, but found no evidence of local immune suppression or failure which would explain the abnormal host response to a common pathogen in this rare condition. We introduced a new treatment regimen for these pa tients. oral rifampicin and oral clindamycin together for 10 weeks. Ten of the 18 patients have responded well with no evidence of recurrence 2-22 mon ths after one course of treatment, and 15 of the 18 responded after two or three courses.