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JAAD Case Rep 2023 Sep 3;39:122-124. Epub 2023 Jul 3.

Department of Dermatology, University of Virginia, Charlottesville, Virginia.

J Dermatolog Treat 2023 Dec;34(1):2235443

Department of Dermatology, Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, China.

Dissecting cellulitis of the scalp (DCS) is a rare recurrent inflammatory disease of unknown etiology. Ideal treatment of DCS remains unclear. We treated DCS with 2940-nm erbium Yttrium-aluminum-garnet (YAG) laser in 12 patients and assessed the efficacy by Physicians Global Assessment (PGA), number of inflammatory nodules, abscesses, and area of alopecia. Read More

Pediatr Dermatol 2023 May 30. Epub 2023 May 30.

Department of Dermatology, Skin Cancer Center, Ruhr-University Bochum, Bochum, Germany.

Alopecic and aseptic nodules of the scalp (AANS) and dissecting cellulitis of the scalp (DCS) are rare, closely related conditions of young men that exclusively affect the hair-bearing scalp. We describe a 9-year-old boy who presented with a 6-year history of chronically relapsing, sterile, partially scarring nodules of the scalp and facial skin. Histopathology revealed mixed inflammatory infiltrates consisting of neutrophils, macrophages, lymphocytes, and plasma cells in the deep dermis, consistent with the morphological pattern of suppurative, partly granulomatous dermatitis. Read More

N Engl J Med 2023 Apr 22;388(17):1608. Epub 2023 Apr 22.

Baylor College of Medicine, Houston, TX

Front Med (Lausanne) 2023 28;10:1132574. Epub 2023 Mar 28.

Department of Dermatology, Yueyang Hospital of Integrated Traditional Chinese and Western Medicine, Shanghai University of Traditional Chinese Medicine, Shanghai, China.

Rationale: Perifolliculitis capitis abscedens et suffodiens (PCAS), also known as dissecting cellulitis of the scalp (DCS), is a part of the "follicular occlusion tetrad" that also includes acne conglobate (AC), hidradenitis suppurativa (HS), and pilonidal sinus, which share the same pathogenic mechanism, such as follicular occlusions, follicular ruptures, and follicular infections.

Patient Concerns: A 15-year-old boy had multiple rashes on the scalp accompanied by pain.

Diagnosis: The patient was diagnosed with PCAS or DCS based on the clinical manifestations and laboratory examinations. Read More

Acta Dermatovenerol Croat 2022 Dec;30(4):256-260

Efstathios Rallis, MD, Department of Biomedical Sciences University of West Attica, Athens, Greece;

Perifolliculitis capitis abscedens et suffodiens (PCAS) is a rare, suppurative dermatosis of the scalp, the etiology of which remains unknown. It is characterized by the development of comedones, perifollicular pustules, firm or fluctuant and itchy or painful nodules and abscesses of the scalp, connected by communicating sinuses that may lead to the formation of scarring and irreversible alopecia. Treatment of PCAS is challenging, often leading to unsatisfactory results. Read More

Clin Exp Dermatol 2023 Apr;48(5):528-530

Sce de Dermatologie, CHU et Inserm1098, Besançon, France.

Although retinoids are considered as the most effective treatment, management of dissecting cellulitis of the scalp (DCS) is often challenging. A multicentre retrospective study was conducted to evaluate the efficacy of anti-tumour necrosis factor (TNF) agents in treating DCS after failure of other conventional treatments. Twenty-six patients were included. Read More

Skin Appendage Disord 2023 Jan 4;9(1):73-75. Epub 2022 Oct 4.

Section of Dermatology, Department of Clinical Medicine and Surgery, University of Naples Federico II, Naples, Italy.

Introduction: In the field of hair transplantation (HT) surgery, transplantation techniques from autologous tissue dominate. The most widely used techniques are follicular unit transplantation, also known as strip technique, and follicular unit extraction.

Case Presentation: We report a case of an HT sequence of particular interest because of its unusual clinical presentation, chronic relapsing nature, and aggressiveness. Read More

J Dermatol 2022 Nov 23;49(11):1173-1177. Epub 2022 Aug 23.

Department of Dermatology, Beijing Youan Hospital, Capital Medical University, Beijing, China.

Dissecting cellulitis of the scalp (DCS) is a rare skin disease and understudied. The aim of the study was to collect the demographic, clinical features and laboratory tests of patients with DCS in a dermatology outpatient clinic. A cross-sectional study was conducted in a department of dermatology in Beijing. Read More

Dermatol Ther 2022 Oct 15;35(10):e15763. Epub 2022 Aug 15.

Department of Dermatologic Surgery, Institute of Dermatology, Chinese Academy of Medical Sciences and Peking Union Medical College, Nanjing, Jiangsu, China.

Perifolliculitis capitis abscedens et suffodiens (PCAS) is a chronic skin inflammatory disease characterized by relapsing folliculitis and painful, fluctuant abscesses, sinus tracts, and scars. The treatment of PCAS is challenging and clinical practice varies a lot, and how to choose the best treatment for PCAS is a real problem for clinicians. We reviewed articles providing treatment options for patients with PCAS in different databases. Read More

J Drugs Dermatol 2022 Jul;21(7):800-802

Dissecting cellulitis of the scalp (DCS) also known as perifolliculitis capitis abscedens et suffodiens (PCAS) is a chronic, relapsing, inflammatory dermatosis consisting of edematous sterile pustules and nodules resulting in sinus tracts and scarring alopecia. Although first described as infectious in 1903, DCS is primarily an inflammatory process that can precede a secondary infection; this is similarly true of the other conditions within the follicular occlusion tetrad: hidradenitis suppurativa (HS), acne conglobata, and pilonidal sinus. Read More

Dermatol Ther 2022 Aug 17;35(8):e15626. Epub 2022 Jun 17.

Department of Dermatology, Consorci Sanitari Parc Taulí, Sabadell, Autonomous University of Barcelona, Sabadell, Spain.

Australas J Dermatol 2022 Aug 4;63(3):404-406. Epub 2022 May 4.

University of Melbourne, Parkville, Victoria, Australia.

Clin Rheumatol 2022 Aug 23;41(8):2553-2560. Epub 2022 Apr 23.

Division of Rheumatology, Department of Medicine, and Division of Dermatology, Keck School of Medicine, University of Southern California and Los Angeles County, Los Angeles, CA, USA.

Dissecting cellulitis of the scalp (DCS) is a rare, primary neutrophilic cicatricial alopecia of unknown etiology. The disease follows a chronic, relapsing, and remitting course which may ultimately lead to scar formation and alopecia. The association of seronegative peripheral and/or axial spondyloarthritis in patients with hidradenitis suppurativa (HS) and acne conglobata (AC) is well established. Read More

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 Dermatol 2022 Jul 22;49(7):e230-e231. Epub 2022 Mar 22.

Department of Dermatology, Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, China.

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

J Cutan Med Surg 2022 11;26(4):443. Epub 2021 Nov 11.

Sanitary Dermatology Outpatient Clinic, Health Department of Rio Grande do Sul State - SES/RS, Porto Alegre, Brazil.

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 Sep;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 Apr 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 Mar 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