Top

Published in:

Open Access 22-09-2023 | Acne Inversa | Review

Treatments for Dissecting Cellulitis of the Scalp: A Systematic Review and Treatment Algorithm

Published in: Dermatology and Therapy | Issue 11/2023

Abstract

Background

Dissecting cellulitis of the scalp (DCS) is a chronic inflammatory skin condition characterized by abscesses, nodules, fistulas, and scarring alopecia. Management of this oftentimes debilitating dermatosis can be challenging due to its recalcitrant nature. There is limited data regarding the efficacy of treatment options for DCS.

Objective

The aim of this study was to conduct a systematic review of the literature to explore the efficacy and safety of reported DCS treatments.

Methods

In October 2022, MEDLINE and EMBASE databases were searched for articles on treatments for DCS. Studies that contained outcome efficacy data for DCS treatments were included. Reviews, conference abstracts, meta-analyses, commentaries, non-relevant articles, and articles with no full-text available were excluded. Data extraction was performed by two independent reviewers.

Results

A total of 110 relevant articles with 417 patients were identified. A majority of studies (86.4%) were case reports or series. Treatment options included systemic antibiotics, oral retinoids, biologics, procedural treatments, combination agents, and topical treatments. Oral retinoids and photodynamic therapy were the most extensively studied medical and procedural interventions, respectively.

Conclusion

Overall, randomized controlled trials are needed to evaluate various treatment regimens for DCS and provide patients with a robust, evidence-based approach to therapy.

Vasanth V, Chandrashekar BS. Follicular occlusion tetrad. Indian Dermatol Online J. 2014;5(4):491–3. https://doi.org/10.4103/2229-5178.142517. CrossRefPubMedPubMedCentral

Malviya N, Garg A. Comorbidities and Systemic Associations. In: A Comprehensive Guide to Hidradenitis Suppurativa. Elsevier; 2022:69–76. https://doi.org/10.1016/B978-0-323-77724-7.00008-5

Brănişteanu DE, Molodoi A, Ciobanu D, et al. The importance of histopathologic aspects in the diagnosis of dissecting cellulitis of the scalp. Rom J Morphol Embryol. 2009;50(4):719–724.

Badaoui A, Reygagne P, Cavelier-Balloy B, et al. Dissecting cellulitis of the scalp: a retrospective study of 51 patients and review of literature. Br J Dermatol. 2016;174(2):421–3. https://doi.org/10.1111/bjd.13999. CrossRefPubMed

Higgins JPT, Altman DG, Gøtzsche PC, et al. The Cochrane Collaboration’s tool for assessing risk of bias in randomised trials. BMJ. 2011;343:d5928. https://doi.org/10.1136/bmj.d5928

Wells G, Shea B, Peterson J, Welch V, Losos M, Tugwell P. The Newcastle-Ottawa Scale (NOS) for assessing the quality of nonrandomised studies in meta-analyses.

Moher D, Liberati A, Tetzlaff J, Altman DG, PRISMA Group. Preferred reporting items for systematic reviews and meta-analyses: the PRISMA statement. PLoS Med. 2009;6(7):e1000097. https://doi.org/10.1371/journal.pmed.1000097

Gamissans M, Romaní J, López-Llunell C, Riera-Martí N, Sin M. Dissecting cellulitis of the scalp: A review on clinical characteristics and management options in a series of 14 patients. Dermatol Ther. 2022;35(8):e15626. https://doi.org/10.1111/dth.15626

Karpouzis A, Giatromanolaki A, Sivridis E, Kouskoukis C. Perifolliculitis capitis abscedens et suffodiens successfully controlled with topical isotretinoin. Eur J Dermatol. 2003;13(2):192–5. PubMed

10.

Navarro-Triviño FJ, Almazán-Fernández FM, Ródenas-Herranz T, Ruiz-Villaverde R. Dissecting cellulitis of the scalp successfully treated with topical resorcinol 15. Dermatol Ther. 2020;33(3):e13406. https://doi.org/10.1111/dth.13406

11.

Scheinfeld N. Dissecting cellulitis (Perifolliculitis Capitis Abscedens et Suffodiens): a comprehensive review focusing on new treatments and findings of the last decade with commentary comparing the therapies and causes of dissecting cellulitis to hidradenitis suppurativa. Dermatol Online J. 2014;20(5):22692. PubMed

12.

Abdennader S, Vignon-Pennamen MD, Hatchuel J, Reygagne P. Alopecic and aseptic nodules of the scalp (pseudocyst of the scalp): a prospective clinicopathological study of 15 cases. Dermatology. 2011;222(1):31–5. https://doi.org/10.1159/000321475. CrossRefPubMed

13.

Melo DF, Jorge Machado C, Bordignon NL, da Silva LL, Ramos PM. Lymecycline as a treatment option for dissecting cellulitis and folliculitis decalvans. Dermatol Ther. 2020;33(6):e14051. https://doi.org/10.1111/dth.14051

14.

Chu S, Michelle L, Ekelem C, Sung CT, Rojek N, Mesinkovska NA. Oral isotretinoin for the treatment of dermatologic conditions other than acne: a systematic review and discussion of future directions. Arch Dermatol Res. 2021;313(6):391–430. https://doi.org/10.1007/s00403-020-02152-4. CrossRefPubMed

15.

Melo DF, Trüeb RM, Dutra H, Lima MMDA, Machado CJ, Dias MFRG. Low-dose isotretinoin as a therapeutic option for dissecting cellulitis. Dermatol Ther. 2020;33(6):e14273. https://doi.org/10.1111/dth.14273

16.

Lee CN, Chen W, Hsu CK, Weng TT, Lee JYY, Yang CC. Dissecting folliculitis (dissecting cellulitis) of the scalp: a 66-patient case series and proposal of classification. J Dtsch Dermatol Ges. 2018;16(10):1219–26. https://doi.org/10.1111/ddg.13649. CrossRefPubMed

17.

Prasad SC, Bygum A. Successful treatment with alitretinoin of dissecting cellulitis of the scalp in keratitis-ichthyosis-deafness syndrome. Acta Derm Venereol. 2013;93(4):473–4. https://doi.org/10.2340/00015555-1499. CrossRefPubMed

18.

Vossen ARJV, Ardon CB, Zee HH, Lubberts E, Prens EP. The anti-inflammatory potency of biologics targeting tumour necrosis factor-α, interleukin ( IL )-17A, IL -12/23 and CD 20 in hidradenitis suppurativa: an ex vivo study. Br J Dermatol. 2019;181(2):314–23. https://doi.org/10.1111/bjd.17641. CrossRefPubMedPubMedCentral

19.

Frechet L, Puzenat E, Charollais R, et al. Dissecting cellulitis of the scalp treated by tumour necrosis factor inhibitors: a case series. Eur J Dermatol. 2021;31(1):81–5. https://doi.org/10.1684/ejd.2021.3969. CrossRefPubMed

20.

Awad A, Sinclair R. Treatment of dissecting cellulitis of the scalp with Tildrakizumab. Australas J Dermatol. 2022;63(3):404–6. https://doi.org/10.1111/ajd.13860. CrossRefPubMed

21.

Babalola F, Chima M, Jobarteh R, Gottlieb A. Refractory Dissecting cellulitis of the scalp treated with risankizumab. J Drugs Dermatol. 2022;21(3):313–4. https://doi.org/10.36849/JDD.6699. CrossRefPubMed

22.

Muzumdar S, Parikh S, Strober B. Treatment of refractory dissecting cellulitis of the scalp with guselkumab: Case report. J Dermatol Dermatol Surg. 2020;24(1):52–3. https://doi.org/10.4103/jdds.jdds-50-19. CrossRef

23.

De Bedout V, Harper H, Miteva M, Lev-Tov H. Treatment dissecting cellulitis of the scalp with secukinumab. J Drugs Dermatol. 2021;20(7):776–7. https://doi.org/10.36849/JDD.5615. CrossRefPubMed

24.

Adrian RM, Arndt KA. Perifolliculitis capitis: successful control with alternate-day corticosteroids. Ann Plast Surg. 1980;4(2):166–9. CrossRefPubMed

25.

Segurado-Miravalles G, Camacho-Martínez FM, Arias-Santiago S, et al. Epidemiology, clinical presentation and therapeutic approach in a multicentre series of dissecting cellulitis of the scalp. J Eur Acad Dermatol Venereol. 2017;31(4):e199–200. https://doi.org/10.1111/jdv.13948. CrossRefPubMed

26.

Gupta M, Mahajan VK, Mehta KS, Chauhan PS. Zinc therapy in dermatology: A review. Dermatol Res Pract. 2014. https://doi.org/10.1155/2014/709152

27.

Berne B, Venge P, Ohman S. Perifolliculitis capitis abscedens et suffodiens (Hoffman). Complete healing associated with oral zinc therapy. Arch Dermatol. 1985;121(8):1028–1030.

28.

Kobayashi H, Aiba S, Tagami H. Successful treatment of dissecting cellulitis and acne conglobata with oral zinc. Br J Dermatol. 1999;141(6):1137–8. https://doi.org/10.1046/j.1365-2133.1999.03223.x. CrossRefPubMed

29.

Kurokawa I. Perifolliculitis capitis abscedens et suffodiens successfully treated with Saireito. J Dermatol. 2019;46(8):e299–301. https://doi.org/10.1111/1346-8138.14832. CrossRefPubMed

30.

Baneu NS, Bloancă VA, Szilagyi D, et al. Surgical management of dissecting cellulitis of the scalp using free latissimus dorsi flap and meshed split–thickness skin graft: A case report. Medicine. 2021;100(4):e24092. https://doi.org/10.1097/MD.0000000000024092

31.

Dellon AL, Orlando JC. Perifolliculitis capitis: surgical treatment for the severe case. Ann Plast Surg. 1982;9(3):254–9. https://doi.org/10.1097/00000637-198209000-00012. CrossRefPubMed

32.

de Melo WC, Avci P, de Oliveira MN, et al. Photodynamic inactivation of biofilm: taking a lightly colored approach to stubborn infection. Expert Rev Anti Infect Ther. 2013;11(7):669–93. https://doi.org/10.1586/14787210.2013.811861. CrossRefPubMedPubMedCentral

33.

Wu HE, Liu YB, Cui L, Xu GJ, Sun XD. A prospective study of the effect of fire micro-needling plus 5% topical ALA-PDT for the treatment of dissecting cellulitis of the scalp. Photodiagnosis Photodyn Ther. 2021;35:102396. https://doi.org/10.1016/j.pdpdt.2021.102396

34.

Su Y, Xu Q, Zhang C, Zhang C. Photodynamic therapy pre-treated by fire needle combined with isotretinoin in the treatment of refractory perifolliculitis capitis abscedens et suffodiens: Case report. Photodiagnosis Photodyn Ther. 2021;33:102103. https://doi.org/10.1016/j.pdpdt.2020.102103

35.

He J, Yang Y, Jin L, et al. 20% ALA-PDT pretreated by fire needle in patients with dissecting cellulitis of the scalp: An interim analysis. Photodiagnosis Photodyn Ther. 2021;36:102544. https://doi.org/10.1016/j.pdpdt.2021.102544

36.

Scheinfeld NS. A case of dissecting cellulitis and a review of the literature. Dermatol Online J. 2003;9(1):8. PubMed

37.

Krasner BD, Hamzavi FH, Murakawa GJ, Hamzavi IH. Dissecting cellulitis treated with the long-pulsed Nd:YAG laser. Dermatol Surg. 2006;32(8):1039–44. https://doi.org/10.1111/j.1524-4725.2006.32227.x. CrossRefPubMed

38.

Chui CT, Berger TG, Price VH, Zachary CB. Recalcitrant scarring follicular disorders treated by laser-assisted hair removal: a preliminary report. Dermatol Surg. 1999;25(1):34–7. https://doi.org/10.1046/j.1524-4725.1999.08100.x. CrossRefPubMed

39.

Xu M, Yan J. 2940-nm multifractional erbium:yttrium-aluminum-garnet laser for the treatment of dissecting cellulitis of the scalp: Case reports and literature review. J Dermatol. 2022;49(7):e230–1. https://doi.org/10.1111/1346-8138.16344. CrossRefPubMed

40.

Boyd AS, Binhlam JQ. Use of an 800-nm pulsed-diode laser in the treatment of recalcitrant dissecting cellulitis of the scalp. Arch Dermatol. 2002;138(10):1291–3. https://doi.org/10.1001/archderm.138.10.1291. CrossRefPubMed

41.

Glass LF, Berman B, Laub D. Treatment of perifolliculitis capitis abscedens et suffodiens with the carbon dioxide laser. J Dermatol Surg Oncol. 1989;15(6):673–6. https://doi.org/10.1111/j.1524-4725.1989.tb03608.x. CrossRefPubMed

42.

Chinnaiyan P, Tena LB, Brenner MJ, Welsh JS. Modern external beam radiation therapy for refractory dissecting cellulitis of the scalp. Br J Dermatol. 2005;152(4):777–9. https://doi.org/10.1111/j.1365-2133.2005.06536.x. CrossRefPubMed

43.

Paul S, Bach D, LeBoeuf NR, Devlin PM, Lipworth AD. Successful use of brachytherapy for a severe hidradenitis suppurativa variant. Dermatol Ther. 2016;29(6):455–8. https://doi.org/10.1111/dth.12393. CrossRefPubMed

44.

McMullan FH, Zeligman I. Perifolliculitis capitis abscedens et suffodiens; its successful treatment with x-ray epilation. AMA Arch Derm. 1956;73(3):256–63. https://doi.org/10.1001/archderm.1956.01550030058005. CrossRefPubMed

45.

MOYER DG, WILLIAMS RM. Perifolliculitis capitis abscedens et suffodiens. A report of six cases. Arch Dermatol. 1962;85:378–384. https://doi.org/10.1001/archderm.1962.01590030076010

46.

Wasserman E. Perifolliculitis capitis abscedens et suffodiens with rheumatoid arthritis; report of a case. AMA Arch Derm Syphilol. 1951;64(6):787–9. https://doi.org/10.1001/archderm.1951.01570120122015. CrossRefPubMed

47.

Aboul-Fettouh N, Silapunt S, Mays S, Nguyen T. Intracavitary Foam Sclerotherapy in Dissecting Cellulitis of the Scalp. Dermatol Surg. 2021;47(9):1317–9. https://doi.org/10.1097/DSS.0000000000003035. CrossRefPubMed

48.

Asemota E, Chang YC, Goldberg LJ. Innovative management of recalcitrant dissecting cellulitis with compression therapy. JAMA Dermatol. 2016;152(11):1280–1. https://doi.org/10.1001/jamadermatol.2016.2743. CrossRefPubMed

49.

Díaz-Pérez LM, Escobar-Ramírez K, Sánchez-Dueñas LE. A new familial presentation of dissecting cellulitis: The genetic implications on scarring alopecias. JAAD Case Rep. 2020;6(8):705–7. https://doi.org/10.1016/j.jdcr.2020.05.027. CrossRefPubMedPubMedCentral

50.

Shaffer N, Billick RC, Srolovitz H. Perifolliculitis capitis abscedens et suffodiens. Resolution with combination therapy. Arch Dermatol. 1992;128(10):1329–31. CrossRefPubMed

51.

Ross EK, Tan E, Shapiro J. Update on primary cicatricial alopecias. J Am Acad Dermatol. 2005;53(1):1–37; quiz 38–40. https://doi.org/10.1016/j.jaad.2004.06.015

52.

Federico A, Rossi A, Caro G, et al. Are dissecting cellulitis and hidradenitis suppurativa different diseases? Clin Dermatol. 2021;39(3):496–9. https://doi.org/10.1016/j.clindermatol.2021.01.002. CrossRefPubMed

53.

Garg A, Kirby JS, Lavian J, Lin G, Strunk A. Sex- and Age-Adjusted Population Analysis of Prevalence Estimates for Hidradenitis Suppurativa in the United States. JAMA Dermatol. 2017;153(8):760–4. https://doi.org/10.1001/jamadermatol.2017.0201. CrossRefPubMedPubMedCentral

54.

Alikhan A, Sayed C, Alavi A, et al. North American clinical management guidelines for hidradenitis suppurativa: A publication from the United States and Canadian Hidradenitis Suppurativa Foundations: Part II: Topical, intralesional, and systemic medical management. J Am Acad Dermatol. 2019;81(1):91–101. https://doi.org/10.1016/j.jaad.2019.02.068. CrossRefPubMedPubMedCentral

55.

Dunn LK, Gaar LR, Yentzer BA, O’Neill JL, Feldman SR. Acitretin in dermatology: a review. J Drugs Dermatol. 2011;10(7):772–82. PubMed

56.

Bechara FG, Podda M, Prens EP, et al. Efficacy and safety of adalimumab in conjunction with surgery in moderate to severe hidradenitis suppurativa: the SHARPS Randomized Clinical Trial. JAMA Surg. 2021;156(11):1001–9. https://doi.org/10.1001/jamasurg.2021.3655. CrossRefPubMed

57.

Jolliffe DS, Sarkany I. Perifolliculitis capitis abscedens et suffoidiens (dissecting cellulitis of the scalp). Clin Exp Dermatol. 1977;2(3):291–3. https://doi.org/10.1111/j.1365-2230.1977.tb02574.x. CrossRefPubMed

58.

Brook I. Recovery of anaerobic bacteria from a case of dissecting cellulitis. Int J Dermatol. 2006;45(2):168–9. https://doi.org/10.1111/j.1365-4632.2005.02594.x. CrossRefPubMed

59.

Cárdenas ML, López F, Moreno LH. Report of a patient with acne conglobata and perifolliculitis capitis abscedens et suffodiens. Colomb Med. 2011;42(2):224–7. https://doi.org/10.25100/cm.v42i2.775. CrossRef

60.

Koshelev MV, Garrison PA, Wright TS. Concurrent hidradenitis suppurativa, inflammatory acne, dissecting cellulitis of the scalp, and pyoderma gangrenosum in a 16-year-old boy. Pediatr Dermatol. 2014;31(1):e20-21. https://doi.org/10.1111/pde.12196. CrossRefPubMed

61.

Varshney N, Al Hammadi A, Sam H, Watters AK. Perifolliculitis capitis abscedens et suffodiens in an 18-year-old Aboriginal Canadian patient: case report and review of the literature. J Cutan Med Surg. 2007;11(1):35–9. https://doi.org/10.2310/7750.2007.00004. CrossRefPubMed

62.

CORMIE RL. Perifolliculitis capitis abscedens et suffodiens. Scott Med J. 1962;7:488–493. https://doi.org/10.1177/003693306200701105

63.

GASNER WG. Perifolliculitis capitis abscedens et suffodiens; report of a case and response to therapy. N Y State J Med. 1957;57(5):947.

64.

Greenblatt DT, Sheth N, Teixeira F. Dissecting cellulitis of the scalp responding to oral quinolones. Clin Exp Dermatol. 2008;33(1):99–100. https://doi.org/10.1111/j.1365-2230.2007.02598.x. CrossRefPubMed

65.

Onderdijk AJ, Boer J. Successful treatment of dissecting cellulitis with ciprofloxacin. Clin Exp Dermatol. 2009;34(7):e507. https://doi.org/10.1111/j.1365-2230.2009.03595.x

66.

Ramesh V. Dissecting cellulitis of the scalp in 2 girls. Dermatologica. 1990;180(1):48–50. https://doi.org/10.1159/000247985. CrossRefPubMed

67.

Mittal RR, Gill SS, Jot T. Follicular occlusion triad. Indian J Dermatol Venereol Leprol. 1993;59(2):88–9.

68.

Salim A, David J, Holder J. Dissecting cellulitis of the scalp with associated spondylarthropathy: case report and review. J Eur Acad Dermatol Venereol. 2003;17(6):689–91. https://doi.org/10.1046/j.1468-3083.2003.00731.x. CrossRefPubMed

69.

Scerri L, Williams HC, Allen BR. Dissecting cellulitis of the scalp: response to isotretinoin. Br J Dermatol. 1996;134(6):1105–8. CrossRefPubMed

70.

Bjellerup M, Wallengren J. Familial perifolliculitis capitis abscedens et suffodiens in two brothers successfully treated with isotretinoin. J Am Acad Dermatol. 1990;23(4 Pt 1):752–3. https://doi.org/10.1016/s0190-9622(08)81076-6. CrossRefPubMed

71.

Benvenuto ME, Rebora A. Fluctuant nodules and alopecia of the scalp. Perifolliculitis capitis abscedens et suffodiens. Arch Dermatol. 1992;128(8):1115–1117, 1118–1119. https://doi.org/10.1001/archderm.128.8.1115b

72.

El Sayed F, Ammoury A, Dhaybi R, Aftimos G, Bazex J. Perifolliculitis capitis abscedens et suffodiens: an unusual case triggered by trauma. J Eur Acad Dermatol Venereol. 2006;20(9):1143–4. https://doi.org/10.1111/j.1468-3083.2006.01639.x. CrossRefPubMed

73.

Healsmith MF, Graham-Brown RAC. Treatment of perifolliculitis capitis abscedens et suffodiens with isotretinoin. J Dermatol Treat. 1992;3(1):27–8. CrossRef

74.

Khaled A, Zeglaoui F, Zoghlami A, Fazaa B, Kamoun MR. Dissecting cellulitis of the scalp: response to isotretinoin. J Eur Acad Dermatol Venereol. 2007;21(10):1430–1. https://doi.org/10.1111/j.1468-3083.2007.02239.x. CrossRefPubMed

75.

Koca R, Altinyazar HC, Ozen OI, Tekin NS. Dissecting cellulitis in a white male: response to isotretinoin. Int J Dermatol. 2002;41(8):509–13. https://doi.org/10.1046/j.1365-4362.2002.01552_3.x. CrossRefPubMed

76.

Libow LF, Friar DA. Arthropathy associated with cystic acne, hidradenitis suppurativa, and perifolliculitis capitis abscedens et suffodiens: treatment with isotretinoin. Cutis. 1999;64(2):87–90. PubMed

77.

Marquis K, Christensen LC, Rajpara A. Dissecting Cellulitis of the Scalp with Excellent Response to Isotretinoin. Pediatr Dermatol. 2017;34(4):e210–1. https://doi.org/10.1111/pde.13143. CrossRefPubMed

78.

Melo DF, Lemes LR, Alves AL, Frattini SC, Obadia DL, Tortelly VD. Low-dose oral isotretinoin in a young female with dissecting cellulitis. Pediatr Dermatol. 2021;38(6):1573–4. https://doi.org/10.1111/pde.14829. CrossRefPubMed

79.

Mihić LL, Tomas D, Situm M, et al. Perifolliculitis capitis abscedens et suffodiens in a caucasian: diagnostic and therapeutic challenge. Acta Dermatovenerol Croat. 2011;19(2):98–102. PubMed

80.

Mundi JP, Marmon S, Fischer M, Kamino H, Patel R, Shapiro J. Dissecting cellulitis of the scalp. Dermatol Online J. 2012;18(12):8. PubMed

81.

Omulecki A, Dabkowski J, Zak-Prelich M. Perifolliculitis capitis abscedens et suffodiens–a case report. Med Sci Monit. 2000;6(3):602–4. PubMed

82.

Ortiz-Prieto A, Pulpillo-Ruiz A, Conejo-Mir J. Dissecting cellulitis of the scalp. Actas Dermosifiliogr. 2017;108(8):778. https://doi.org/10.1016/j.ad.2016.04.025. CrossRefPubMed

83.

Scavo S, Lazzaro Danzuso G, La Rocca R, Magro G, Neri S. Isotretinoin in Perifolliculitis capitis abscedens et suffodiens: A case report and review of the literature. Clin Drug Invest. 2002;22(11):791–4. https://doi.org/10.2165/00044011-200222110-00007. CrossRef

84.

Schewach-Millet M, Ziv R, Shapira D. Perifolliculitis capitis abscedens et suffodiens treated with isotretinoin (13-cis-retinoic acid). J Am Acad Dermatol. 1986;15(6):1291–2. https://doi.org/10.1016/s0190-9622(86)80042-1. CrossRefPubMed

85.

Stites PC, Boyd AS. Dissecting cellulitis in a white male: a case report and review of the literature. Cutis. 2001;67(1):37–40. PubMed

86.

Taylor AE. Dissecting cellulitis of the scalp: response to isotretinoin. Lancet. 1987;2(8552):225. https://doi.org/10.1016/s0140-6736(87)90818-x. CrossRefPubMed

87.

Tchernev G. Folliculitis et perifolliculitis capitis abscedens et suffodiens controlled with a combination therapy: Systemic antibiosis (Metronidazole Plus Clindamycin), dermatosurgical approach, and high-dose isotretinoin. Indian J Dermatol. 2011;56(3):318–20. https://doi.org/10.4103/0019-5154.82492. CrossRefPubMedPubMedCentral

88.

Sand FL, Thomsen SF. Off-label use of TNF-alpha inhibitors in a dermatological university department: retrospective evaluation of 118 patients. Dermatol Ther. 2015;28(3):158–65. https://doi.org/10.1111/dth.12222. CrossRefPubMed

89.

Navarini AA, Trüeb RM. 3 cases of dissecting cellulitis of the scalp treated with adalimumab: control of inflammation within residual structural disease. Arch Dermatol. 2010;146(5):517–20. https://doi.org/10.1001/archdermatol.2010.16. CrossRefPubMed

90.

Alsantali A, Almalki B, Alharbi A. Recalcitrant dissecting cellulitis of the scalp treated successfully with adalimumab with hair regrowth: A case report. Clin Cosmet Invest Dermatol. 2021;14((Alsantali A., santli26@hotmail.com) Department of Dermatology, Hair Disorder Unit, King Fahad Armed Forces Hospital, Jeddah, Saudi Arabia):455–458. https://doi.org/10.2147/CCID.S301451

91.

Kurokawa I. Perifolliculitis capitis abscedens et suffodiens with hidradenitis suppurativa and nodulocystic acne treated with adalimumab. J Dermatol. 2021;48(8):e374–5. https://doi.org/10.1111/1346-8138.15945. CrossRefPubMed

92.

Martin-García RF, Rullán JM. Refractory dissecting cellulitis of the scalp successfully controlled with adalimumab. P R Health Sci J. 2015;34(2):102–4. PubMed

93.

Masnec IS, Franceschi N. Perifolliculitis capitis abscedens et suffodiens treated with anti-tumor necrosis factor-alpha – Possible new treatment option. Acta Dermatovenerol Croat. 2018;26(3):255–9.

94.

Maxon E, Modlin K, Durso TA, Miletta NR. A case report of tumor necrosis factor alpha inhibitors in an active duty service member with dissecting cellulitis of the scalp resistant to treatment. Mil Med. 2020;185(7–8):e1309–11. https://doi.org/10.1093/milmed/usz394. CrossRefPubMed

95.

Minakawa S, Matsuzaki Y, Rokunohe D, et al. Hidradenitis suppurativa with perifolliculitis capitis abscedens et suffodiens successfully treated with a human anti-tumour necrosis factor monoclonal antibody. Clin Exp Dermatol. 2021;46(8):1586–8. https://doi.org/10.1111/ced.14789. CrossRefPubMed

96.

Sukhatme SV, Lenzy YM, Gottlieb AB. Refractory dissecting cellulitis of the scalp treated with adalimumab. J Drugs Dermatol. 2008;7(10):981–3. PubMed

97.

Takahashi T, Yamasaki K, Terui H, et al. Perifolliculitis capitis abscedens et suffodiens treatment with tumor necrosis factor inhibitors: A case report and review of published cases. J Dermatol. 2019;46(9):802–7. https://doi.org/10.1111/1346-8138.14998. CrossRefPubMed

98.

Sanchez-Diaz M, Martinez-Lopez A, Salvador-Rodriguez L, Montero-Vilchez T, Arias-Santiago S, Molina-Leyva A. The role of biologic treatment in special scenarios in hidradenitis suppurativa: Facial and nape phenotype, dissecting cellulitis of the scalp, and lymphedema. Dermatol Ther. 2021;34(2):e14829. https://doi.org/10.1111/dth.14829

99.

Brandt HRC, Malheiros APR, Teixeira MG, Machado MCR. Perifolliculitis capitis abscedens et suffodiens successfully controlled with infliximab. Br J Dermatol. 2008;159(2):506–7. https://doi.org/10.1111/j.1365-2133.2008.08674.x. CrossRefPubMed

100.

Syed TA, Asad ZUA, Salem G, Garg K, Rubin E, Agudelo N. Dissecting cellulitis of the scalp: A rare dermatological manifestation of Crohn’s disease. ACG Case Rep J. 2018;5(3). https://doi.org/10.14309/crj.2018.8

101.

Wollina U, Gemmeke A, Koch A. Dissecting cellulitis of the scalp responding to intravenous tumor necrosis factor-alpha antagonist. J Clin Aesthetic Dermatol. 2012;5(4):36–9.

102.

Powers MC, Mehta D, Ozog D. Cutting Out the Tracts: Staged Excisions for Dissecting Cellulitis of the Scalp. Dermatol Surg. 2017;43(5):738–40. https://doi.org/10.1097/DSS.0000000000001005. CrossRefPubMed

103.

Williams CN, Cohen M, Ronan SG, Lewandowski CA. Dissecting cellulitis of the scalp. Plast Reconstr Surg. 1986;77(3):378–82. https://doi.org/10.1097/00006534-198603000-00005. CrossRefPubMed

104.

Arneja JS, Vashi CN, Gursel E, Lelli JL. Management of fulminant dissecting cellulitis of the scalp in the pediatric population: Case report and literature review. Can J Plast Surg. 2007;15(4):211–4. https://doi.org/10.1177/229255030701500406. CrossRefPubMedPubMedCentral

105.

Bachynsky T, Antonyshyn OM, Ross JB. Dissecting folliculitis of the scalp. A case report of combined treatment using tissue expansion, radical excision, and isotretinoin. J Dermatol Surg Oncol. 1992;18(10):877–880. https://doi.org/10.1111/j.1524-4725.1992.tb02920.x

106.

Bellew SG, Nemerofsky R, Schwartz RA, Granick MS. Successful treatment of recalcitrant dissecting cellulitis of the scalp with complete scalp excision and split-thickness skin graft. Dermatol Surg. 2003;29(10):1068–70. https://doi.org/10.1046/j.1524-4725.2003.29305.x. CrossRefPubMed

107.

Housewright CD, Rensvold E, Tidwell J, Lynch D, Butler DF. Excisional surgery (scalpectomy) for dissecting cellulitis of the scalp. Dermatol Surg. 2011;37(8):1189–91. https://doi.org/10.1111/j.1524-4725.2011.02049.x. CrossRefPubMed

108.

Maintz L, Betz RC, Allam JP, et al. Keratitis-ichthyosis-deafness syndrome in association with follicular occlusion triad. Eur J Dermatol. 2005;15(5):347–52. PubMed

109.

Moschella SL, Klein MH, Miller RJ. Perifolliculitis capitis abscedens et suffodiens. Report of a successful therapeutic scalping. Arch Dermatol. 1967;96(2):195–197.

110.

Ramasastry SS, Granick MS, Boyd JB, Futrell JW. Severe perifolliculitis capitis with osteomyelitis. Ann Plast Surg. 1987;18(3):241–4. https://doi.org/10.1097/00000637-198703000-00011. CrossRefPubMed

111.

Nijhawan RI. Staged full-thickness excisions and porcine xenograft placement for extensive dissecting cellulitis of the scalp. Dermatol Surg. 2019;45(10):1324–7. https://doi.org/10.1097/DSS.0000000000001732. CrossRefPubMed

112.

Unal S, Unal S, Kuyucu S, Kuyucu N. Dissecting cellulitis of the scalp: A case report. Int Pediatr. 2004;19(2):103–5.

113.

Feng Y, Zhang Y, Guo H, et al. Treatment of dissecting cellulitis of the scalp with 10% ALA-PDT. Lasers Surg Med. 2019;51(4):332–8. https://doi.org/10.1002/lsm.23016. CrossRefPubMed

114.

Zhang L, Wang P, Shi L, et al. Topical 5-aminolevulinic acid photodynamic therapy improved refractory acne conglobata and perifolliculitis capitis abscedens et suffodiens rather than hidradenitis suppurativa. J Innovative Opt Health Sci. 2016;9(1). https://doi.org/10.1142/S1793545816400022

115.

Liu H, Ding A, Aloke G, et al. Surgical interventions combined with photodynamic therapy in the treatment of Perifolliculitis Capitis Abscendens et Suffodiens: Report of 5 cases. Photodiagnosis Photodyn Ther. 2020;30:101660. https://doi.org/10.1016/j.pdpdt.2020.101660

116.

Feng H, Zhu C, Jin H. The efficacy and safety of 5-Aminolevulinic acid photodynamic therapy (ALA-PDT) as an adjunct therapy for symptoms in patients with dissecting cellulitis of the scalp: A retrospective study. Photodiagnosis Photodyn Ther. 2021;34:102322. https://doi.org/10.1016/j.pdpdt.2021.102322

117.

Cui X, Zhu J, Yao X, Zhu W, Xu P, Wu X. Photodynamic therapy combined with dermatosurgical approach for Perifolliculitis Capitis Abscedens et Suffodiens. Photodiagnosis Photodyn Ther. 2020;30:101767. https://doi.org/10.1016/j.pdpdt.2020.101767

118.

Liu Y, Ma Y, Xiang LH. Successful treatment of recalcitrant dissecting cellulitis of the scalp with ALA-PDT: case report and literature review. Photodiagnosis Photodyn Ther. 2013;10(4):410–3. https://doi.org/10.1016/j.pdpdt.2013.03.008. CrossRefPubMed

119.

Yan J, Zhang G, Liao C, Wang X, Shi L. ALA-iPDT for follicular occlusion tetrad concomitant with pachyonychia congenital type II and ankylosing spondylitis. Photodiagnosis Photodyn Ther. 2022;39:102891. https://doi.org/10.1016/j.pdpdt.2022.102891

120.

Zhan Y, Chen X, Zhou Y, Zou P, Xiao R. Dissecting cellulitis of the scalp successfully treated with ALA-PDT: Case report. Photodiagnosis Photodyn Ther. 2018;24:182–4. https://doi.org/10.1016/j.pdpdt.2018.10.001. CrossRefPubMed

121.

Garelli V, Didona D, Paolino G, Didona B, Calvieri S, Rossi A. Dissecting cellulitis: responding to topical steroid and oral clindamycin. G Ital Dermatol Venereol. 2017;152(3):324–5. https://doi.org/10.23736/S0392-0488.16.05296-2. CrossRefPubMed

122.

Georgala S, Korfitis C, Ioannidou D, Alestas T, Kylafis G, Georgala C. Dissecting cellulitis of the scalp treated with rifampicin and isotretinoin: case reports. Cutis. 2008;82(3):195–8. PubMed

123.

Ankad BS, Anusha HL, Nikam BP. Trichoscopic assessment of treatment response in dissecting cellulitis of scalp treated with combination therapy: A case report. Dermatol Ther. 2022;35(9):e15718. https://doi.org/10.1111/dth.15718

124.

Bolz S, Jappe U, Hartschuh W. Successful treatment of perifolliculitis capitis abscedens et suffodiens with combined isotretinoin and dapsone. J Dtsch Dermatol Ges. 2008;6(1):44–7. https://doi.org/10.1111/j.1610-0387.2007.06399.x. CrossRefPubMed

125.

Donovan J. Dissecting cellulitis (DSC) after interferon beta-1a treatment and scalp trauma. JAAD Case Rep. 2015;1(5):303–4. https://doi.org/10.1016/j.jdcr.2015.07.003. CrossRefPubMedPubMedCentral

126.

Goldsmith PC, Dowd PM. Successful therapy of the follicular occlusion triad in a young woman with high dose oral antiandrogens and minocycline. J R SOC MED. 1993;86(12):729–30. CrossRefPubMedPubMedCentral

127.

Jacobs F, Metzler G, Kubiak J, Röcken M, Schaller M. New approach in combined therapy of perifolliculitis capitis abscedens et suffodiens. Acta Derm Venereol. 2011;91(6):726–7. https://doi.org/10.2340/00015555-1146. CrossRefPubMed

128.

Ljubojevic S, Pasic A, Lipozencic J, Skerlev M. Perifolliculitis capitis abscedens et suffodiens. J Eur Acad Dermatol Venereol. 2005;19(6):719–21. https://doi.org/10.1111/j.1468-3083.2005.01215.x. CrossRefPubMed

Title: Treatments for Dissecting Cellulitis of the Scalp: A Systematic Review and Treatment Algorithm
Publication date: 22-09-2023
Keywords: Acne Inversa
Photodynamic Therapy
Adalimumab
Acne
Published in: Dermatology and Therapy / Issue 11/2023
Print ISSN: 2193-8210
Electronic ISSN: 2190-9172
DOI: https://doi.org/10.1007/s13555-023-01018-7

Webinar | 08-11-2023 | 18:00 (CET)

Keynote Webinar | Spotlight on Diet and Diabetes

Watch now

An expert-led symposium exploring the prevention and management of type 2 diabetes through dietary interventions. Highlights include discussion of the recent EASD guidelines, therapeutic diets, food types and processing, plus psychological factors that influence patient success, and the drivers of healthy eating and diabetes control.

Prof. Mike Lean

Prof. Falko Sniehotta

Keynote Webinar | Spotlight on Diet and Diabetes

Springer Medicine

Abstract

Background

Objective

Methods

Results

Conclusion

Please log in to get access to this content

Other articles of this Issue 11/2023

Skin Clearance is Associated with Reduced Treatment Failure in Patients with Psoriasis: Real-World Evidence from the CorEvitas Psoriasis Registry

Dupilumab Safety and Efficacy in a Phase III Open-Label Extension Trial in Children 6–11 Years of Age with Severe Atopic Dermatitis

Hair Loss Profiles and Ritlecitinib Efficacy in Patients with Alopecia Areata: Post Hoc Analysis of the ALLEGRO Phase 2b/3 Study

Neurotrophin-4 and Brain-Derived Neurotrophic Factor Serum Levels in Renal Transplant Recipients with Chronic Pruritus

Cost-Effectiveness of Secukinumab Versus Other Biologics in the Treatment of Moderate-to-Severe Plaque Psoriasis: The Chinese Healthcare System Perspective

Letter to the Editor: Response to Fitzgerald T et al. Long-Term Psoriasis Control with Guselkumab, Adalimumab, Secukinumab, or Ixekizumab in the USA

Keynote Webinar | Spotlight on Diet and Diabetes