Clinical and experimental dermatologySep 24, 2017

Using light-based treatment for a rare scalp inflammation causing hair loss

GLP-1 Therapies Weekly Brief ↗PubMed ↗DOI ↗

Updated Mar 9, 2026

Abstract

A 26-year-old man experienced significant improvement in folliculitis decalvans after 25 months of systemic photodynamic therapy.

Folliculitis decalvans is estimated to account for approximately 10% of primary cicatricial alopecia cases.
Dysfunctional immune activity and Staphylococcus aureus are potentially key factors in the condition.
Systemic photodynamic therapy using ultraviolet light and porfimer sodium showed promising results as a monotherapy.
This treatment is associated with strong antibacterial effects and minimal resistance.
Systemic photodynamic therapy may also enhance local immune response and improve scar healing.
Significant adverse effects from this therapy are rare when appropriate aftercare is provided.

Simplified

Folliculitis decalvans (FD) is classified as a primary neutrophilic cicatricial alopecia, and is estimated to account for approximately 10% of all cases of primary cicatricial alopecia. The role of dysfunctional immune activity and the presence of bacteria, particularly Staphylococcus aureus, appear pivotal. We describe a 26-year-old man with a 4-year history of FD that was recalcitrant to numerous systemic and topical therapies, whose disease was virtually cleared during a follow-up of 25 months following a course of treatment with systemic photodynamic therapy (PDT) using ultraviolet light (100-140 J/cm) with porfimer sodium 1 mg/kg as monotherapy. This is the first report of the use of systemic PDT as a treatment for FD. Systemic PDT has potent antibacterial effects with little or no resistance. In addition, systemic PDT provides local immunomodulation and improved scar healing. Significant adverse effects following systemic PDT with appropriate aftercare are rare. This case demonstrates that systemic PDT is a useful therapy option in the treatment of recalcitrant FD. 2

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Using light-based treatment for a rare scalp inflammation causing hair loss

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