Dissecting Cellulitis

Is an uncommon scarring scalp hair loss disorder characterized by painful nodules, drainage of puss, sinus tracts, keloid/ thick scar formation, and scarring alopecia. It most commonly affects black males between the ages of 20 and 40.  The cause of DC is unknown but may have a genetic predisposition with autosomal dominant inheritance. It may be triggered shaving and other scalp irritants (i.e. helmets).  DC may be associated with Hidradenitis suppurativa, acne conglobata, pilonidal cysts, and secondary bacterial infections.  It can be managed with oral antibiotics, oral isotretinoin, tumor necrosis factor (TNF) inhibitors, and surgical excision.

 

References: 

- Martin-Garcıa RF, Rullan JM. Refractory dissecting cellulitisof the scalp successfully controlled with adalimumab.P R Health Sci J 2015;34(2):102–104.​

- Badaoui A et al. Dissecting cellulitis of the scalp: a retrospective study of 51 patients and review of literature.  Br J Dermatol. 2016 Feb;174(2):421-3​

- Powers MC, Mehta D, Ozog D.  Cutting Out the Tracts: Staged Excisions for Dissecting Cellulitis of the Scalp. Dermatol Surg. 2017 May;43(5):738-740