{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,17]],"date-time":"2026-09-17T07:04:59Z","timestamp":1789628699287,"version":"build-2803163510"},"reference-count":16,"publisher":"Wiley","license":[{"start":{"date-parts":[[2026,9,16]],"date-time":"2026-09-16T00:00:00Z","timestamp":1789516800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2026,9,16]],"date-time":"2026-09-16T00:00:00Z","timestamp":1789516800000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["J Deutsche Derma Gesell"],"abstract":"<jats:title>Summary<\/jats:title>\n                  <jats:p>Folliculitis decalvans (FD) is a chronic neutrophilic cicatricial alopecia characterized by recurrent scalp inflammation, pustules, tufted hairs, and progressive permanent hair loss. Owing to its relapsing course and the absence of standardized treatment guidelines, therapeutic management remains challenging. This systematic review summarizes available treatment approaches and reported outcomes in FD. A systematic literature search of PubMed, Web of Science, Embase, and Cochrane databases was conducted according to PRISMA guidelines and registered in PROSPERO (CRD42023467796). Studies published between 1999 and December 2024 reporting treatment outcomes in at least one patient with FD were included. Full remission was defined as complete absence of inflammatory activity with stable disease, while partial remission indicated clinical improvement without relevant alopecia progression. Overall, 64\u00a0studies comprising 300\u00a0patients were included, mainly retrospective studies, case series, and case reports with low levels of evidence. Antibiotic\u2010based therapies, particularly rifampicin\u2013clindamycin combinations, showed favorable initial responses but frequent relapse after discontinuation. Isotretinoin demonstrated comparatively durable responses, with remission rates up to 82%. Biologic and targeted immunomodulatory therapies, including TNF\u2010\u03b1 inhibitors, apremilast, and various JAK inhibitors, showed promising outcomes in refractory cases. Current evidence supports individualized long\u2010term treatment strategies focused on inflammation control and prevention of irreversible scarring.<\/jats:p>","DOI":"10.1111\/ddg.70607","type":"journal-article","created":{"date-parts":[[2026,9,17]],"date-time":"2026-09-17T06:34:04Z","timestamp":1789626844000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Navigating Treatments in Folliculitis Decalvans: A Comprehensive Systematic Review"],"prefix":"10.1111","author":[{"given":"Imad","family":"Al\u2010naesan","sequence":"first","affiliation":[{"name":"Department of Dermatology Inselspital Bern University Hospital  Bern Switzerland"},{"name":"Dermatology Venerology and Allergy Medical University Innsbruck  Innsbruck Austria"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0002-1613-5877","authenticated-orcid":false,"given":"Thomas","family":"Trafoier","sequence":"additional","affiliation":[{"name":"Dermatology Venerology and Allergy Medical University Innsbruck  Innsbruck Austria"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Daniela","family":"Krepper","sequence":"additional","affiliation":[{"name":"Health Outcomes Research Unit University Hospital of Psychiatry II Medical University of Innsbruck  Innsbruck Austria"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Johannes M.","family":"Giesinger","sequence":"additional","affiliation":[{"name":"Health Outcomes Research Unit University Hospital of Psychiatry II Medical University of Innsbruck  Innsbruck Austria"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Florian","family":"Regensberger","sequence":"additional","affiliation":[{"name":"Dermatology Venerology and Allergy Medical University Innsbruck  Innsbruck Austria"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Simone","family":"Cazzaniga","sequence":"additional","affiliation":[{"name":"Department of Dermatology Inselspital Bern University Hospital  Bern Switzerland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Pierre A.","family":"de de Viragh","sequence":"additional","affiliation":[{"name":"Department of Dermatology Inselspital Bern University Hospital  Bern Switzerland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6466-2199","authenticated-orcid":false,"given":"Seyed M.","family":"Seyed Jafari","sequence":"additional","affiliation":[{"name":"Department of Dermatology Inselspital Bern University Hospital  Bern Switzerland"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,9,16]]},"reference":[{"issue":"3","key":"e_1_2_7_2_1","doi-asserted-by":"crossref","first-page":"454","DOI":"10.1159\/000529301","article-title":"Folliculitis Decalvans Has a Heterogeneous Microbiological Signature and Impaired Immunological Response","volume":"239","author":"Moreno\u2010Arrones OM","year":"2023","journal-title":"Dermatology"},{"issue":"3","key":"e_1_2_7_3_1","doi-asserted-by":"crossref","first-page":"328","DOI":"10.1111\/ddg.15905","article-title":"Quality of Life in Patients with Scarring and Non\u2010scarring Alopecia: An Exploratory Cross\u2010sectional Study","volume":"24","author":"Franz A","year":"2026","journal-title":"J Dtsch Dermatol Ges"},{"issue":"4","key":"e_1_2_7_4_1","doi-asserted-by":"crossref","first-page":"238","DOI":"10.1111\/j.1529-8019.2008.00204.x","article-title":"Folliculitis Decalvans","volume":"21","author":"Otberg 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Course and Treatment Analysis of Long\u2010standing Cases","volume":"19","author":"Bunagan MJK","year":"2015","journal-title":"J Cutan Med Surg"},{"key":"e_1_2_7_12_1","doi-asserted-by":"crossref","DOI":"10.1016\/j.pdpdt.2021.102356","article-title":"Photodynamic Therapy Should Be Considered for the Treatment of Folliculitis Decalvans","volume":"35","author":"Yang L","year":"2021","journal-title":"Photodiagnosis Photodyn Ther"},{"issue":"6","key":"e_1_2_7_13_1","doi-asserted-by":"crossref","first-page":"1085","DOI":"10.1016\/j.jaad.2015.02.1120","article-title":"Treatment of Folliculitis Decalvans with Photodynamic Therapy: Results in 10 Patients","volume":"72","author":"Miguel\u2010Gomez L","year":"2015","journal-title":"J Am Acad Dermatol"},{"key":"e_1_2_7_14_1","doi-asserted-by":"crossref","first-page":"2381","DOI":"10.2147\/CCID.S422077","article-title":"Refractory Folliculitis Decalvans Treatment Success with a Novel Surgical Excision Approach Using Guarded High\u2010Tension 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