Photodynamic therapy should be considered for the treatment of folliculitis decalvans

• Folliculitis decalvans is a rare neutrophilic inflammation of the scalp. • Some cases are resistant to therapy and relapse quickly. • We propose to use photodynamic therapy as an alternative method for the treatment of folliculitis decalvans. Background: Different therapies such as clindamycin, rifampicin, isotretinoin, or corticosteroids have been used for folliculitis decalvans with poor results. Recently, PDT has been used for treating folliculitis decalvans more frequently. However, the efficacy of PDT for treating folliculitis decalvans is lacking consensus. In this study, we conducted a retrospective analysis to evaluated the status of PDT for the treatment of folliculitis decalvans. Methods: 13 cases of folliculitis decalvans patients were treated with ALA-PDT. The treatment totals 3 times, and the interval between each treatment was 10–14 days. A follow-up was conducted at 12 months after the last treatment. The condition was graded according to the following evaluation criteria: recovery, significant improvement, moderate improvement, ineffective. Results: A total of 7 cases improved significantly, and 6 cases improved moderately followed the first treatment. After the second treatment, 10 cases showed significant improvement, and 2 cases responded poorer than the first treatment. After the third treatment, 4 cases recovered, 7 cases improved significantly, and 2 case moderately improved. At the 12-months follow-up, 9 out of 13 patients were well controlled and with no recurrence. The other 4 patients relapsed. Conclusion: In summary, photodynamic therapy shows overall favorable effect on folliculitis decalvans and should be considered as a method for the treatment of folliculitis decalvans.