Folliculitis Decalvans (FD) is a rare neutrophilic inflammation of the scalp characterized by painful recurrent purulent follicular exudation resulting in primary cicatricial alopecia. Although it is not an infection, bacterial superantigens may trigger inflammation and antimicrobials, namely tetracyclines, have been tried previously with good results and are often the first therapeutic approach. There are also anedoctal improvements reported with isotretinoin, dapsone, adalimumab and infliximab, topical tacrolimus, ndYagLASER and photodynamic therapy. Most of our FD patients are treated with minocycline. In patients with FD minocycline is our first choice, usually in monotherapy. In some non-responsive patients we associated rifampicin or clarithromycin. The main reason for the study is that minocycline use is associated with hyperpigmentation. In our opinion, this benefic action in FD course may turn this drug a good candidate for minocycline substitution during summertime in countries in which sun expose may induce minocycline hyperpigmentation.

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