Zakharov S. V., Makarenko O. V.

PHARMACOTHERAPEUTIC TACTICS OF TREATMENT OF ABSCEDING PERIFOLICULITIS OF THE SCAL

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About the author:

Zakharov S. V., Makarenko O. V.

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LITERATURE REVIEWS

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Scientific article

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Abscessing perifolliculitis of the scalp, also known as dissecting cellulitis of the scalp, belongs to the rare destructive forms of the follicular occlusion syndrome and is characterized by a chronic recurrent course with the development of deep purulent-inflammatory lesions of the hair follicles, formation of subcutaneous abscesses, sinus tracts, scarring alopecia, and pronounced cosmetic defects. The disease significantly worsens patients’ quality of life, is accompanied by psychoemotional disturbances, and often demonstrates resistance to conventional therapy. The relevance of this issue is due to the limited number of large-scale clinical studies, the absence of unified treatment protocols, and the complexity of selecting the optimal therapeutic strategy. The aim of the study was to determine current directions of pharmacotherapy for abscessing perifolliculitis of the scalp with an analysis of the effectiveness of the main pharmacological groups of drugs and their combinations. The study was performed in the format of a systematic analysis of contemporary literature sources, clinical studies, and retrospective observations using methods of comparative and critical analysis of evidence-based medicine data. It was established that topical therapy has limited effectiveness due to the deep involvement of the follicular apparatus and the formation of subcutaneous abscesses; however, it may be used as an adjunctive component of treatment in the early stages of the disease. Systemic antibiotics occupy a leading role in therapy, providing both antibacterial and anti-inflammatory effects. Combinations of clindamycin and rifampicin, as well as tetracycline-class drugs, demonstrated high clinical effectiveness. Retinoids, particularly isotretinoin, are considered among the most effective treatment options for chronic and recurrent forms of the disease due to their ability to normalize keratinization processes and reduce inflammatory activity. In severe resistant cases, biological agents targeting TNF-α, IL-17, and IL-23, as well as JAK inhibitors, are considered promising, as they influence the key mechanisms of the chronic inflammatory process and contribute to achieving long-term remission. Thus, the modern therapeutic strategy for abscessing perifolliculitis of the scalp should be based on an individualized comprehensive approach taking into account the clinical form, severity of the disease course, and the patient’s response to treatment.

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Bibliography:

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Publication of the article:

«Bulletin of problems biology and medicine», 2026 Issue 2, 181, 67-72 pages, index UDC 616.594.1-002.156:611.91

DOI:

10.29254/2077-4214-2026-2-181-67-72