Dissecting cellulitis of the scalp
medical condition
Dissecting cellulitis of the scalp, also known as dissecting folliculitis, perifolliculitis capitis abscedens et suffodiens of Hoffman, perifolliculitis abscedens et suffodiens, or folliculitis abscedens et suffodiens, is an inflammatory condition of the scalp that can lead to scarring alopecia, which begins with deep inflammatory nodules, primarily over occiput, that progresses to coalescing regions of boggy scalp. Boggy tissue has a high fluid level that results in a spongy feeling. Isotretinoin proves to be the medicine of choice for the treatment of the disease.
Demographics
Dissecting cellulitis of the scalp predominantly affects adult men of African descent, typically between the ages of 20 and 40. It has been documented globally and can occasionally occur in women, children, and individuals of other racial backgrounds. There are rare instances of it running in families.
Symptoms
The condition generally originates on the top (vertex) or back (occiput) of the head, initially presenting as simple inflamed hair follicles, developing into a network of deeper lesions, including pus-filled bumps, interconnected abscesses, and sinus tracts that can leak fluid. Because the condition is long-lasting and prone to relapsing, the persistent inflammation ultimately leads to permanent, scarring hair loss (alopecia) and the formation of thick, keloid scars across the scalp.
Causes and associated conditions
The underlying mechanism may be driven by the blockage of hair follicles. When a blocked follicle swells and bursts, it releases trapped keratin and bacteria into the surrounding tissue.
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