Folliculitis decalvans managed with long pulsed Nd:YAG; our experience and a review of the literature (2022)

Type of publication:
Conference abstract

*Oh S.; *Badrol S.; *Tzortzis S.; El Shimy N.; Murdoch S.;

Lasers in Medical Science. Conference: British Medical Laser Association Annual Conference, BMLA 2022. Edinburgh United Kingdom. 37(9) (pp 3769), 2022. Date of Publication: December 2022.

Background Folliculitis decalvans (FD) is a rare inflammatory disorder predominantly of the scalp that can progress to cicatrical alopecia. Mainstay treatment is antibiotics; however, resolution is difficult, and relapse is common. Only three cases of FD treated with neodymium:yttrium aluminum garnet (Nd:YAG) laser exist in the literature. We present two cases of recalcitrant FD managed with long pulsed Nd:YAG laser and a literature review. Study Design Retrospective case series of two patients with FD treated with long pulsed Nd:YAG laser. Results The first case was a 49-year-old male with Fitzpatrick skin type II. Previous unsuccessful treatment included oral doxycycline and isotretinoin. A course of eight sessions of Nd:YAG laser (CynergyTM, Cynosure) was performed with settings of 50J/cm<inf>2</inf>, 20msec pulse duration, and 10mm spot size. Complete resolution of FD was achieved and remained stable without adjuvant treatment at 6 months post laser. The second case was a 46-year-old male with Fitzpatrick skin type IV with 9-years history of FD. Previously, oral antibiotics (clindamycin, rifampicin, erythromycin, ciprofloxacin) as well as dapsone, intralesional triamcinolone and acitretin treatment was trialled without success. A total of four successful treatments with Nd:YAG laser was completed with settings of 30J/cm<inf>2</inf>, 40msec pulse duration, and 15mm spot size. Treatment is ongoing. Conclusion Our experience of Nd:YAG laser treatment of FD have been positive. All cases from literature report full resolution of FD maintained without adjuvant treatment between 6 months to 1.5 years after final treatment. Treatment with Nd:YAG laser is an option for patients suffering from recalcitrant FD.

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