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Clin Exp Dermatol 2021 Jun 7. Epub 2021 Jun 7.

Department of Dermatology, Hirosaki University Graduate School of Medicine, Aomori, Japan.

Hidradenitis suppurativa (HS) is a chronic autoinflammatory skin disorder characterized by recurrent painful nodules, abscesses, sinus tracts, and scarring on intertriginous body areas. Perifolliculitis capitis abscedens et suffodiens (PCAS) is a component of the follicular occlusion tetrad along with HS, acne conglobata, and pilonidal cyst. We report a case of HS with PCAS that was successfully treated with adalimumab, a human anti-tumor necrosis factor (TNF) monoclonal antibody. Read More

Clin Cosmet Investig Dermatol 2021 10;14:455-458. Epub 2021 May 10.

Department of Pathology, King Fahad Armed Forces Hospital, Jeddah, Saudi Arabia.

Dissecting cellulitis (DC) of the scalp or perifolliculitis capitis abscedens et suffodiens is a rare chronic inflammatory condition of the scalp manifested by perifollicular pustules, nodules, abscesses and sinuses that result into scarring alopecia. Treatment of DC is challenging and often disappointing. We report a 38-year-old male patient with DC for 5 years, and multiple topical and systemic therapies had shown poor effect. Read More

J Dermatol 2021 May 7. Epub 2021 May 7.

Department of Dermatology, Meiwa Hospital, Nishimoya, Japan.

Eur J Dermatol 2021 Feb;31(1):81-85

Dpt of Dermatology and Inserm Unit 1098 RIGHT, University of Franche Comté and University Hospital, Besançon, France.

Background: Dissecting cellulitis of the scalp (DCS), also known as Hoffmann disease or perifolliculitis capitis abscedens et suffodiens, is a rare disease characterized by chronic inflammation of the scalp. Treatment is difficult and often disappointing.

Objectives: To report our experience of TNF inhibitors in a series of patients with DCS. Read More

Dermatol Ther 2021 03 15;34(2):e14829. Epub 2021 Feb 15.

Hidradenitis Suppurativa Clinic, Department of Dermatology, Hospital Universitario Virgen de las Nieves, Granada, Spain.

Hidradenitis suppurativa (HS) is a chronic inflammatory disorder affecting the hair follicle which typically affects the axilla, inguinal, submammary, and perianal areas. Atypical HS, such as facial HS, dissecting cellulitis of the scalp (DCS), nape HS, and HS lymphedema has also been described. There is scarce evidence about the treatment of atypical HS. Read More

Photodiagnosis Photodyn Ther 2021 Mar 20;33:102103. Epub 2020 Dec 20.

Department of Dermato-venereology, The Second Hospital, Cheeloo College of Medicine, Shandong University, Jinan, Shandong, 250012, China. Electronic address:

Perifolliculitis capitis abscedens et suffodiens (PCAS) is a rare chronic inflammatory dermatosis of the scalp, which is a refractory and recrudescent disease. Symptoms of PCAS include follicular papules, suppurative nodules, cysts, sinuses, fistulas, and these usually evolve into patchy alopecia or cicatricial alopecia, which seriously affects the beauty and quality of life of patients. In this paper, we report 3 cases of PCAS each of whom received 5% 5-aminolevulinic acid-based photodynamic therapy (ALA-PDT) combined with isotretinoin. Read More

JAAD Case Rep 2020 Aug 1;6(8):705-707. Epub 2020 Jun 1.

Department of Dermatology, Dermika Centro Dermatológico Láser, Guadalajara, Mexico.

Photodiagnosis Photodyn Ther 2020 Jun 17;30:101767. Epub 2020 Apr 17.

Department of Medical Cosmetology, Department of Dermatology, Affiliated Hospital of Nantong University, Nantong 226001, China. Electronic address:

Perifolliculitis capitis abscedens et suffodiens (PCAS) is a rare, chronic, suppurative and inflammatory scalp disease with aetiology and pathogenesis not completely understood. The treatment of PCAS usually represents a challenging problem with frustrating outcome (1). Photodynamic therapy (PDT) is an approach considered to be useful to treat tumors, bacterial and fungal infections (2-4). Read More

Dermatol Ther 2020 05 3;33(3):e13406. Epub 2020 May 3.

Department of Dermatology, Hospital Universitario San Cecilio, Granada, Spain.

Photodiagnosis Photodyn Ther 2020 Jun 25;30:101660. Epub 2020 Feb 25.

Department of Dermatology, Xiangya Hospital of Central South University, Changsha 410005, China. Electronic address:

Perifolliculitis capitis abscedens et suffodiens (PCAS), also known as dissecting cellulitis of the scalp (DCS), is a rare, chronic, suppurative inflammatory disease of the scalp which may evolve into cicatricial alopecia. Its refractory nature has a detrimental impact on patients' quality of life. Here, we report five cases of PCAS treated with 5% 5-aminolevulinic acid-based photodynamic therapy (ALA-PDT), prior to which different methods of surgical intervention were given. Read More

Mil Med 2020 08;185(7-8):e1309-e1311

Department of Dermatology, San Antonio Military Health System Laser Surgery and Scar Center, 2200 Bergquist Drive, San Antonio, TX 78236.

Dissecting cellulitis of the scalp represents a disease of follicular occlusion that may be worsened by tight-fitting clothing, such as the patrol cap or advanced combat helmet used by military service members. Treatment poses a challenge to the clinician, and the treatment of choice, oral retinoids, may not improve the condition sufficiently to maintain active duty status. Early treatment augmentation with tumor necrosis factor-alpha inhibitors may improve efficacy of oral retinoids and prevent medical separation of the active duty service member. Read More

An Bras Dermatol 2019 Sep - Oct;94(5):608-611. Epub 2019 Sep 30.

Alopecia Outpatient Clinic, Hospital Naval Marcílio Dias, Rio de Janeiro, RJ, Brazil.

Dissecting cellulitis is an inflammatory, chronic, and recurrent disease of the hair follicles that mainly affects young Afro-descendent men. Trichoscopy is a method of great diagnostic value for disorders of the scalp. Clinical and trichoscopic findings of dissecting cellulitis are heterogeneous and may present features common to non-cicatricial and scarring alopecia. Read More

Dermatol Surg 2019 10;45(10):1324-1327

Department of Dermatology, University of Texas Southwestern Medical Center, Dallas, Texas.

J Eur Acad Dermatol Venereol 2019 Oct;33 Suppl 6:36-39

Dermatology Clinic, University of Catania, Catania, Italy.

The case of a 24-year-old male patient affected by follicular occlusion tetrad (acne conglobata, hidradenitis suppurativa, pilonidal cyst and dissecting cellulitis of the scalp) associated with clinical signs of pachyonychia congenita (PC)-2 (focal palmoplantar keratoderma, plantar pain, onycodystrophy and multiple cysts) is reported. The diagnosis was supported by genetic analysis that showed heterozygous mutation within the exon 1 of KRT17 gene. This case may reflect different expressions of a phenotypic spectrum induced by a common genetic alteration. Read More

J Dermatolog Treat 2021 Mar 9;32(2):144-149. Epub 2019 Aug 9.

Department of Dermatology, Johns Hopkins School of Medicine, Baltimore, MD, USA.

Background: Dissecting cellulitis is a chronic inflammatory dermatosis that results in disfiguring and painful, purulent lesions. Treatment of patients with disease resistant to standard therapies, including intralesional or topical steroids or antibiotics, can be a dilemma for clinicians.

Methods: We performed a systematic review of the literature in November 2018 to find articles which presented treatment options and outcomes of patients who failed prior treatment with standard therapies. Read More

J Dermatol 2019 Sep 4;46(9):802-807. Epub 2019 Jul 4.

Department of Dermatology, Tohoku University Graduate School of Medicine, Sendai, Japan.

Perifolliculitis capitis abscedens et suffodiens (PCAS) or dissecting cellulitis is a rare condition presenting deep follicular occlusions, follicular ruptures and follicular infections in the scalp area with unknown etiology, which consequently cause primary neutrophilic cicatricial alopecia by the repeated follicular inflammation. PCAS is categorized as one of the "follicular occlusion tetrad" along with hidradenitis suppurativa, acne conglobata and pilonidal cyst. In the pathogenesis of the follicular occlusion tetrad, the involvement of neutrophils and its activator tumor necrosis factor (TNF) have been discussed. Read More

Medicine (Baltimore) 2019 Apr;98(16):e15263

Department of Urology, Qilu Hospital of Shandong University, Jinan, China.

Rationale: Follicular occlusion triad (FOT) is an autosomal recessive inherited disease and no more than 3 variants of the triad have been reported. We give a report in which scrotal elephantiasis is a variant of FOT and further perform a literature review.

Patient Concerns: A 41-year-old man came to us because of a large scrotal cyst and generalized skin lesions that had occurred over the past 10 years. Read More

Rev Prat 2019 Jan;69(1):63

Service de dermatologie, CHU Mohamed VI d'Oujda, université Mohammed Premier, Oujda, Maroc. Laboratoire d'épidémiologie de recherche scientifique et de recherche clinique, Oujda, Maroc.

J Dermatol 2019 08 27;46(8):e299-e301. Epub 2019 Feb 27.

Department of Dermatology, Meiwa Hospital, Nishinomiya, Japan.

Acta Dermatovenerol Croat 2018 Oct;26(3):255-289

Ines Sjerobabski Masnec, MD, Department of Dermatology and Venereology, Sestre milosrdnice University Hospital Center , Vinogradska 29, 10000 Zagreb , Croatia;

The case of a 26-year-old male patient with perifolliculitis capitis abscedens et suffodiens (PCAS) who later developed hidradenitis suppurativa (HS) and exacerbation of acne is presented. The patient did not respond well to conventional treatment including isotretinoin and oral antibiotics. Quality of life was significantly impaired. Read More

J Dtsch Dermatol Ges 2018 Oct;16(10):1219-1227

Department of Dermatology, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan, Taiwan.

Photodiagnosis Photodyn Ther 2018 Dec 2;24:182-184. Epub 2018 Oct 2.

Department of Dermatology, The Second Xiangya Hospital of Central South University, Changsha, 410011, China. Electronic address:

A case of recalcitrant dissecting cellulitis of the scalp (DCS) in a 23-year-old male patient was treated with 4 times of topical ALA-PDT at intervals of 10-15 days. The patient responded well without any unbearable adverse effects and presented satisfactory effects. Before applying this therapy, the patient and his doctors had tried other methods, specifically glucocorticoids, intradermal injection, and even surgical treatment, but none of them had presented satisfactory effects. Read More

J Dtsch Dermatol Ges 2018 Oct 31;16(10):1219-1226. Epub 2018 Aug 31.

Department of Dermatology, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan, Taiwan.

Background And Objectives: Dissecting folliculitis (DF) or dissecting cellulitis of the scalp is regarded as a rare disease with disfiguring scarring alopecia. This study aimed to analyze the features of DF and to propose a classification to define its severity.

Patients And Methods: A hospital-based retrospective study was conducted. Read More

Lasers Surg Med 2019 04 23;51(4):332-338. Epub 2018 Aug 23.

Department of Dermatology, The First Hospital of China Medical University, Shenyang, China.

Background: Dissecting cellulitis of the scalp (DCS) is difficult to be treated and 5-aminolaevulinic acid photodynamic therapy (ALA-PDT) is considered to be a potential treatment for inflammatory skin diseases.

Objective: To analyze the efficacy and safety of ALA-PDT on DCS.

Materials And Methods: The treatment areas of DCS patients were incubated with freshly prepared 10% ALA for 3 hours. Read More

An Bras Dermatol 2017 Sep-Oct;92(5):724-726

Alopecia Outpatient Clinic at Hospital Naval Marcílio Dias (HNMD) - Rio de Janeiro (RJ), Brazil.

Yellow dots are follicular ostium filled with keratin and/or sebum. Initially, they were exclusively associated with alopecia areata. Currently they have also been described in androgenetic alopecia, chronic cutaneous (discoid) lupus erythematosus, and dissecting cellulitis. Read More

Br J Dermatol 2017 10;177(4):e160

Division of Dermatology, University of Arizona, Tucson, AZ, U.S.A.

Br J Dermatol 2017 12 16;177(6):e331-e332. Epub 2017 Nov 16.

Dermatology Clinic, University of Catania, Catania, Italy.

J Am Acad Dermatol 2017 06;76(6):e215-e216

Dermatology Service, Trichology Unit, Ramon y Cajal Hospital, Madrid, Spain; Trichology Unit, Grupo Pedro Jaén, Madrid, Spain.

J Am Acad Dermatol 2017 06;76(6):e213

Dermatology Clinic, University of Catania, Italy. Electronic address:

Pediatr Dermatol 2017 Jul 19;34(4):e210-e211. Epub 2017 Apr 19.

Division of Dermatology, University of Kansas Medical Center, Kansas City, Kansas.

An 18-year-old man presented for evaluation of a 1-year history of painful nodules on the scalp with associated hair loss. Physical examination revealed multiple confluent, fluctuant, boggy nodules on the scalp with overlying alopecic patches. Based on these findings, a diagnosis of dissecting cellulitis of the scalp was made and the patient was successfully treated with oral isotretinoin therapy. Read More