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Clin Cosmet Investig Dermatol 2022 30;15:541-546. Epub 2022 Mar 30.

Department of Plastic Surgery, Shandong Provincial Hospital, Cheeloo College of Medicine, Shandong University, Jinan, Shandong, People's Republic of China.

Follicular occlusion triad (FOT) is a chronic inflammatory skin disease that comprises hidradenitis suppurativa, acne conglobata, and perifolliculitis capitis abscedens et suffodiens and can seriously affect a patient's quality of life. Currently, there is no consensus on the treatment plan for FOT. There are also only a few reports on the treatment of severe FOT. Read More

J Drugs Dermatol 2022 Mar;21(3):313-314

Perifolliculitis capitis abscedens et suffodiens or dissecting cellulitis (DC) is a rare and chronic disease with a predilection for the occipital, vertex, and parietal scalp. DC is characterized by multinodular lesions with purulent drainage and sinus tract formation. It is classically seen in middle-aged males of African descent. Read More

Pediatr Dermatol 2021 Nov 14;38(6):1573-1574. Epub 2021 Oct 14.

Dermatology Department, Rio de Janeiro State University (UERJ), Rio de Janeiro, Brazil.

Dissecting cellulitis (DC) is a chronic inflammatory primary neutrophilic scarring alopecia. It predominantly affects the vertex and occipital regions of Afro-descendent men. Female DC is uncommon, and little is known about this condition in childhood. Read More

Photodiagnosis Photodyn Ther 2021 Dec 20;36:102544. Epub 2021 Sep 20.

Department of Dermatology, First Medical Center of Chinese PLA General Hospital, Beijing, 100853, China. Electronic address:

Background: Dissecting cellulitis of the scalp (DCS) is a rare but distinctive, chronic suppurative condition, and the treatment is a therapeutic challenge. Recently, treatment of DCS with 5-aminolaevulinic acid photodynamic therapy (ALA-PDT) has been considered as a potential option.

Objective: To evaluate the efficacy and safety of 20% ALA-PDT pretreated by fire needle in the treatment of DCS. Read More

Dermatol Surg 2021 09;47(9):1317-1319

Texas Surgical Dermatology PA, Spring, Texas.

J Drugs Dermatol 2021 Jul;20(7):776-777

Photodiagnosis Photodyn Ther 2021 Sep 13;35:102396. Epub 2021 Jun 13.

Department of Dermatology, the Seventh People`s Hospital of Shenyang, Shenyang, 110003, China.

Background: Different therapies have been used for dissecting cellulitis of the scalp (DCS) with poor results. Topical 5-aminolaevulinic acid photodynamic therapy (ALA-PDT) is effective for many inflammatory skin diseases.

Objectives: To evaluate the efficacy and safety of fire micro-needling plus 5% ALA-PDT on DCS. Read More

Clin Exp Dermatol 2021 Dec 29;46(8):1586-1588. Epub 2021 Jun 29.

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

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

Photodiagnosis Photodyn Ther 2021 Jun 4;34:102322. Epub 2021 May 4.

Department of Dermatology, State Key Laboratory of Complex Severe and Rare Diseases, Peking Union Medical Collage Hospital, Chinese Academy of Medical Science and Peking Union Medical Collage, 100730, Beijing, China. Electronic address:

Background: Medicinal therapies such as systemic retinoids and antibiotics have shown efficacy in the treatment of dissecting cellulitis of the scalp (DCS), but refractory cases are common. 5-Aminolevulinic acid photodynamic therapy (ALA-PDT) has been successfully used in medicine-resistant cases in recent years.

Methods: A total of 12 patients who received ALA-PDT in addition to formally failed medicinal therapies were interviewed by telephone regarding improvement of symptoms, satisfaction, and side effects. Read More

J Dermatol 2021 Aug 7;48(8):e374-e375. Epub 2021 May 7.

Department of Dermatology, Meiwa Hospital, Nishimoya, Japan.

J Am Acad Dermatol 2022 04 27;86(4):941-943. Epub 2021 Mar 27.

Department of Dermatology, Tulane University School of Medicine, New Orleans, Louisiana. Electronic address:

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.