Successful treatment of perifolliculitis capitis abscedens et suffodiens with combined isotretinoin and dapsone

J Dtsch Dermatol Ges. 2008 Jan;6(1):44-7. doi: 10.1111/j.1610-0387.2007.06399.x. Epub 2007 Oct 1.
[Article in English, German]

Abstract

Perifolliculitis capitis abscedens et suffodiens (PCAS) is a rare scalp disease of unknown etiology which is hard to treat. It is often accompanied by scarring alopecia, acne conglobata, and recurrent fluctuant abscesses. PCAS belongs to the family of acne inversa (hidradenitis suppurativa). A 19-year-old man presented with PCAS for 2 years; multiple systemic antibiotic therapies and surgical approaches had shown no effect. Monotherapy with isotretinoin 80 mg daily for 4 weeks had not been successful. Combination therapy with dapsone 100 mg and isotretinoin 80 mg daily produced significant improvement. During 4 weeks of treatment significant clearing was achieved. Dapsone was reduced to 50 mg daily after 6 months, while isotretinoin was discontinued gradually. Now the patient is on dapsone 50 mg every other day and has remained free of recurrences for 6 months.

Publication types

  • Case Reports

MeSH terms

  • Adult
  • Dapsone / administration & dosage*
  • Dermatologic Agents / administration & dosage*
  • Drug Therapy, Combination
  • Folliculitis / drug therapy*
  • Folliculitis / pathology*
  • Humans
  • Isotretinoin / administration & dosage*
  • Male
  • Scalp Dermatoses / drug therapy*
  • Scalp Dermatoses / pathology*
  • Treatment Outcome

Substances

  • Dermatologic Agents
  • Dapsone
  • Isotretinoin