Perifolliculitis capitis abscedens et suffodiens in a 7 years male: A case report with review of literature

Abstract

Perifolliculitis capitis abscedens et suffodiens is the least common of the three conditions included in the follicular occlusion triad. It is one of the causes of scarring alopecia in adult males. Clinically it has to be differentiated from other causes of folliculitis affecting the scalp. The histopathology is diagnostic. The treatment is prolonged and the clinical course is characterized by remissions and relapses.

Dissecting Cellulitis of the Scalp: A Review and Case Studies of Surgical Reconstruction

“… 26 Rarely, pediatric cases have been reported with the earliest being 7 years of age. 10 , 19 An androgenic role has been implied by its predilection for men in 20–50s age range and an isolated report of development of the condition in a user of recreational anabolic steroids. 27 …”

“… 4 – 9 The primary pathologic event is obstruction of the pilar infundibulum through hyperkeratosis, accumulation of obstructed follicular products with rupture, and an intense inflammatory reaction at the bulb of the hair follicle. 10 This leads to the formation of pustules that develop into tracts ultimately coalescing to chronically inflamed tissue. 4 Pathologic examination can show reduced follicle number with evidence of follicular rupture and presence of neutrophils.…”

Dissecting Cellulitis of the Scalp: A Rare Dermatological Manifestation of Crohnʼs Disease

“…3 Dissecting cellulitis, hidradenitis suppurativa, and acne conglobate are differentiated mainly on their clinical presentation, with dissecting cellulitis affecting the scalp, hidradenitis suppurativa affecting axillary and anogenital regions, and acne conglobata affecting back, buttocks, and chest. 4 Metastatic Crohn’s disease, a similar disease entity, is characterized by noncaseating granulomas in the skin, but its noncontiguous occurrence with the gastrointestinal tract is a rare manifestation. Although the abscesses in dissecting cellulitis are sterile, it can be associated with secondary bacterial infection.…”

“…Reported organisms include Pseudomonas species, Staphylococcus epidermidis , Propionibacterium acnes , and Prevotella intermedia . 4 …”

“…The well-known associations are arthritis, keratitis, pyoderma gangrenosum, keratitis-ichthyosis-deafness syndrome, pilonidal cysts, and osteomyelitis. 4 A rare association with Crohn’s disease has been documented; this connection is often missed when reviewing mucocutaneous manifestations of inflammatory bowel disease due to the low incidence of dissecting cellulitis itself, as well as its nonfulminant clinical course and the wide array of differential diagnoses that can mask the appropriate diagnosis. 5 , 6 …”