LAUSR

The term ‘chronic folliculocentric pustulosis of the scalp’ (CFPS) was recently coined by Lee et al. to encompass folliculitis decalvans (FD), chronic scalp folliculitis, tufted folliculitis, acne keloidalis nuchae (AKN) and dissecting cellulitis of the scalp (DCS), to emphasize their overlapping characteristics. The pathogenesis of CFPS remains unclear, but an abnormal immune response to Staphylococcus aureus (SA) is postulated. Recent data suggests that other organisms such as Propionibacterium acnes and pathogenic biofilms may be involved. Anti-SA antibiotics are effective for CFPS despite SA not always being isolated. Treatment of CFPS is challenging, and relapse is common. We describe our experience of combination therapy for CFPS consisting of fusidic acid (FA) 500 mg three times daily for 1 month, rifampicin 300 mg twice daily for 2 months and clarithromycin 250 mg twice daily for 3 months. All antibiotics were commenced together. Five patients with CFPS were identified (Table 1). Mean age of CFPS onset was 36 years, with a mean duration of 10 years before commencing the combination. Only one patient had SA confirmed. All patients had tried