Trichoscopy findings in dissecting cellulitis

Abstract

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. This article presents the trichoscopic findings of dissecting cellulitis that help in the diagnosis and consequent institution of the appropriate therapy and better prognosis of the disease.

Low‐dose isotretinoin as a therapeutic option for dissecting cellulitis

“…DCS is part of the "follicular occlusion tetrad," along with acne conglobata, hidradenitis suppurativa and pilonidal sinus, and predominantly affects young Afro-descendent men. 1,2 Therapeutic management of DCS is often challenging. Oral isotretinoin (OI) at 1 mg/kg body weight daily for at least 6 months, in combination with systemic antibiotic, and a burst of oral prednisone at 1 mg/kg with subsequent tapering have been proposed as first-line therapy for moderate to severe disease with a high remission rate.…”

“…The refractory nature of DCS is well recognized, and early institution of appropriate therapy may lead to a better prognosis. 1 Khaled et al recommended OI 1 mg/kg/day, for a minimum of 4 months, and a maintenance dose of not less than 0.75 to 1 mg/kg/day once clinical control is achieved. 6 Badaoui et al reported complete remission in 92% of patients using OI 0.5 to 0.8 mg/kg/day, with some relapses after drug discontinuation.…”

A new familial presentation of dissecting cellulitis: The genetic implications on scarring alopecias

“… 8 Nevertheless, the 3-dimensional yellow dots represents the most specific trichoscopic finding. 9 In our patients, twin A presented heterogeneous trichoscopic features that correlate with severity of disease, whereas twin B showed the classic 3-dimensional yellow dots; thus, trichoscopy helped us to integrate the diagnosis in both cases. Recently, 2 new trichoscopic signs (eastern pancake sign and comedo-like structures) were described as suggestive findings in the diagnosis of alopecic and aseptic nodules of the scalp, that represents a crucial entity of differential diagnosis of DCS.…”

Dissecting cellulitis of the scalp successfully treated with topical resorcinol 15%

“…Although the diagnosis of DC is mainly clinical, the complementary use of trichoscopy as a diagnostic tool has recently been published. 5 Broken hair, black and yellow dots, erythema, pustules, polytrichia, among others, have been described as the main and characteristics tricoscopic findings of DC.…”