Dissecting Cellulitis

Key Points
unusual disorder of the scalp that destroys hair follicles, often causing scarring and hair loss
often accompanied by painful burning and itching
most often affects African-American men

Dissecting Cellulitis, also known as Perifolliculitis Capitis Abscedens et Suffodiens, refers to a fairly rare disorder that destroys hair follicles in the affected area, replacing then with scar tissue. This can cause permanent hair loss. Hair loss can either be gradual, with few symptoms, or can be accompanied by severe itching and burning with rapid hair loss.

Dissecting Cellulitis affects African-American men most commonly, particularly those between the ages of 20 and 40. Dissecting Cellulitis can wax and wane over several years, but will eventually cause scarring on the scalp and permanent hair loss. Severe acne of the face and trunk is also sometimes associated with Dissecting Cellulitis.

Differential Diagnosis (Other conditions with similar appearance)

Staphylococcal Folliculitis
Centrifugal scarring alopecia
Pseudopelade of Brocq
Tinea capitis

Diagnosis

The diagnosis is often made clinically. A culture and scrapings can be done to rule out bacterial and fungal infection, respectively. A scalp Biopsy can also be performed if the diagnosis is in doubt.

Treatment
Isotretinoin
Topical and oral Antibiotics
Epilation and laser surgery in extreme cases

Dissecting Cellulitis, or Perifolliculitis Capitis Abscedens et Suffodiens, responds unpredictably to treatment. If treatment is started early enough it is possible to reverse the disease before hair follicles become permanently damaged or destroyed. Oral Isotretinoin or antibiotics are the primary treatment choices in most cases. Other treatments that have been used successfully include laser treatments and incision and drainage of painful nodules.