Management of definitive alopecia in African Americans
Pierre Bouhanna, Eric Bouhanna in The Alopecias, 2015
Of poorly defined etiology, dissecting cellulitis of the scalp is a mixture of follicular occlusion, acne conglo-bata, and hidradenitis suppurativa. Observed especially in men, it presents clinically with multiple abscesses sometimes coalescing, follicular occlusion, scarring alopecia, hypertrophic scars, or keloids (Figure 12.17). Bacteriological tests are negative (for Staphylococci). Various treatments can be applied: corticosteroids and oral antibiotics, surgical excision, isotretinoin (40 mg/d), zinc sulfate (400 mg orally), cephalosporin (500 mg) + rifampicin (600 mg/d), or incision/drainage for fluctuating abscesses.3,5,8,18
Special Locations
Ashfaq A Marghoob, Ralph Braun, Natalia Jaimes in Atlas of Dermoscopy, 2023
Dissecting cellulitis of the scalp presents as multiple firm, dome-shaped papules, which may coalesce to form plaques and nodules.69 Abscesses and sinus tracts may also be observed. The vertex and occipital area are most commonly affected. The disease is predominantly detected in men of African descent between 20 and 40 years of age. It may occur in association with acne conglobata, hidradenitis suppurativa (follicular occlusion triad), and pilonidal cysts (follicular occlusion tetrad).69,70
Trichoscopy II: Cicatricial Alopecia
Rubina Alves, Ramon Grimalt in Techniques in the Evaluation and Management of Hair Diseases, 2021
Dissecting cellulitis of the scalp (DCS) is a chronic inflammatory condition characterized by recurrent nodules, abscesses, and sinus tracts. It usually starts as simple folliculitis with occlusion of follicular openings mainly on the scalp vertex, followed by perifollicular pustules and painful fluctuant nodules releasing a purulent discharge. With time, lesions evolve into plaques embedding interconnected nodules, abscesses, or draining sinus tracts, resulting in cicatricial tissue.
Approach to treatment of refractory dissecting cellulitis of the scalp: a systematic review
Published in Journal of Dermatological Treatment, 2021
Dissecting Cellulitis of the Scalp (DCS) is a primary neutrophilic scarring alopecia that predominately affects African American males in the 2nd and 3rd decades of life. Patients often present with painful nodules, abscesses, and permanent alopecia which may progress to extensive involvement of interconnected draining sinuses, leading to significant morbidity in more severe disease [1]. Standard therapies often incorporate the use of antibiotics and topical or intralesional steroids but these are often only effective at controlling limited disease in milder presentations [2].
Treatment of dissecting cellulitis of the scalp with erbium: YAG laser: a case series
Published in Journal of Dermatological Treatment, 2023
Mengjun Xu, Suiqing Cai, Jianliang Yan
Dissecting cellulitis of the scalp (DCS), also known as perifolliculitis capitis abscedens et suffodiens (PCAS) or Hoffmann disease, is a rare condition mostly occurs in black males aged 20 to 40 years. The disease presents with suppurative nodules, interconnecting sinuses, and patchy hair loss. Deep follicular occlusion may be the most important pathology in DCS.
Investigational drugs in clinical trials for Hidradenitis Suppurativa
Published in Expert Opinion on Investigational Drugs, 2018
Peter Theut Riis, Linnea R. Thorlacius, Gregor B. Jemec
Several other skin conditions, such as acne, pilonidal cysts, and dissecting cellulitis of the scalp have also been reported to be associated with HS [27–30]. The exact mechanisms linking these various diseases have not been defined in detail but may be linked by systemic inflammation induced by HS.
Related Knowledge Centers
- Inflammation
- Isotretinoin
- Occipital Bone
- Tissue
- Scalp
- Scarring Hair Loss
- Nodule