• Hair Diseases
• Dermatology Clinical Trials

• Dermatology
• Hair Diseases
• Dermatology Clinical Trials

Azithromycin treatment in patients with folliculitis decalvans (FD) resulted in a significant decrease in the number of papules and pustules on the scalp and improved the global subjective score. Rui Oliveira-Soares, MD, CUF Descobertas Hospital, Lisbon, Portugal, presented data from a study that evaluated the effect of azithromycin monotherapy on FD.

Characterized by neutrophilic inflammation of the scalp, FD has an unknown etiology and results in painful, recurrent purulent follicular exudation. The typical treatment for FD includes systemic antimicrobial agents, such as tetracycline antibiotics. However, some tetracyclines may cause hyperpigmentation, particularly in response to sunlight; in contrast, azithromycin is less likely to cause hyperpigmentation and it has been successfully used to treat acne [Hasibur MR, Meraj Z. Mymensingh Med J. 2013; Antonio JR et al. J Dermatolog Treat. 2008; Innocenzi D et al. Acta Dermatovenerol Croat. 2008]. The purpose of this study was to evaluate the safety and efficacy of azithromycin for the treatment of FD.

In this single-arm study, 19 patients with a first diagnosis of FD were enrolled at least 6 months after discontinuing any prior medication. The study treatment was azithromycin monotherapy administered as 500 mg/d for 3 consecutive days every 2 weeks for 6 months. All patients had persistent disease that was either stable or not responsive to prior therapy. The primary end point of the study was the change in the number of intact or crusted papules, or pustules present on the scalp. The secondary end point was change in a global subjective symptoms, including pain, burning sensation, and pruritus.

Treatment with azithromycin resulted in a significant decrease in the number of papular and pustular lesions over 6 months compared with baseline (P < .0001). In addition, the patient-reported symptoms decreased at 1 month and had not increased by 6 months.

In conclusion, Prof Oliveira-Soares stated that, in his opinion, the data from this study suggest that azithromycin treatment of FD resulted in a decrease in the number of papular and pustular lesions, as well as improvement in global subjective symptoms. As a result, Prof Oliveira-Soares suggested that azithromycin may be a reasonable alternative to tetracycline therapy, particularly during the summer months.

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