This study involves patients with Folliculitis decalvans, which is a rare inflammatory condition of the scalp that causes scarring hair loss. The condition leads to patches of hair loss with pustules and crusting, and can cause pain and itching. This study is being conducted in patients whose condition has not responded well to at least two courses of antibiotic treatment. The study will test three different medications: baricitinib, which is taken as a tablet by mouth, adalimumab, which is given as an injection under the skin, and ustekinumab, which is also given as an injection under the skin. These medications work by targeting specific parts of the immune system that may be involved in causing the inflammation seen in this condition.
The purpose of this study is to find out which of these medications works best in reducing the severity of the condition in patients who have not improved with standard antibiotic treatments. The study will measure success by looking at whether there is a significant improvement in the severity of the disease after six months of treatment. This will be assessed using a scoring system that rates the overall appearance and severity of the condition, and the assessment will be done by someone who does not know which treatment the patient is receiving.
The study will last up to twelve months for each participant, with treatment being given for six months. During the study, patients will have regular visits to check how well the treatment is working and to monitor for any side effects. The study will also measure other important outcomes such as pain levels, itching, quality of life, and whether the condition comes back after treatment. If a patient’s condition worsens significantly during the study, they may receive antibiotic treatment as a rescue therapy. Patients will need to have had a recent chest x-ray before starting the study, and they must be between eighteen and sixty-five years old to participate.
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