Perifolliculitis capitis: successful control with alternate-day corticosteroids

Area of Science:

• Dermatology
• Immunology

Background:

• Perifolliculitis capitis is a rare inflammatory scalp condition.
• Standard treatments including antibiotics have shown limited efficacy in some cases.

Observation:

• A patient with recalcitrant perifolliculitis capitis initially received high-dose intravenous antibiotics and topical antibacterial agents without improvement.
• Systemic corticosteroids were then initiated, leading to a rapid decrease in disease activity.

Findings:

• The patient achieved sustained remission of perifolliculitis capitis with a low alternate-day dosage of prednisone (5 mg).
• This suggests that systemic corticosteroids can be an effective treatment for this condition.

Implications:

• High-dose systemic corticosteroid therapy, followed by a rapid transition to alternate-day dosing, presents a reasonable and potentially less aggressive initial treatment strategy for perifolliculitis capitis compared to other reported aggressive therapies.
• This approach may offer a favorable risk-benefit profile for managing this challenging scalp condition.