Approach to treatment of refractory dissecting cellulitis of the scalp: a systematic review

Jamael Thomas, Crystal Aguh

Research output: Contribution to journalReview article

Abstract

Background: Dissecting cellulitis is a chronic inflammatory dermatosis that results in disfiguring and painful, purulent lesions. Treatment of patients with disease resistant to standard therapies, including intralesional or topical steroids or antibiotics, can be a dilemma for clinicians. Methods: We performed a systematic review of the literature in November 2018 to find articles which presented treatment options and outcomes of patients who failed prior treatment with standard therapies. Results: We identified 57 articles of interest, with 53 being case studies or series. Isotretinoin was the most often reported, but the response was limited. Biologics and laser therapy were used less often but demonstrated a better chance of remission. X-ray epilation and surgical excision demonstrated the best remission rates but can be complicated by serious morbidity. Conclusion: We propose a regimen for the treatment of recalcitrant cases of dissecting cellulitis. In the future, more robust studies including randomized control trials are needed to identify the preferred treatment options for refractory dissecting cellulitis.

Original languageEnglish (US)
JournalJournal of Dermatological Treatment
DOIs
StateAccepted/In press - Jan 1 2019

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Cellulitis
Therapeutics
Hair Removal
Isotretinoin
Biological Therapy
Laser Therapy
Skin Diseases
Familial Perifolliculitis Capitis Abscedens Et Suffodiens
Steroids
X-Rays
Anti-Bacterial Agents
Morbidity

Keywords

  • biologics
  • Cicatricial alopecia
  • dissecting cellulitis
  • ethnic skin
  • laser
  • perifolliculitis capitis abscedens
  • refractory
  • scarring alopecia
  • skin of color
  • steroids
  • surgery
  • treatment
  • X-ray epilation

ASJC Scopus subject areas

  • Dermatology

Cite this

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title = "Approach to treatment of refractory dissecting cellulitis of the scalp: a systematic review",
abstract = "Background: Dissecting cellulitis is a chronic inflammatory dermatosis that results in disfiguring and painful, purulent lesions. Treatment of patients with disease resistant to standard therapies, including intralesional or topical steroids or antibiotics, can be a dilemma for clinicians. Methods: We performed a systematic review of the literature in November 2018 to find articles which presented treatment options and outcomes of patients who failed prior treatment with standard therapies. Results: We identified 57 articles of interest, with 53 being case studies or series. Isotretinoin was the most often reported, but the response was limited. Biologics and laser therapy were used less often but demonstrated a better chance of remission. X-ray epilation and surgical excision demonstrated the best remission rates but can be complicated by serious morbidity. Conclusion: We propose a regimen for the treatment of recalcitrant cases of dissecting cellulitis. In the future, more robust studies including randomized control trials are needed to identify the preferred treatment options for refractory dissecting cellulitis.",
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author = "Jamael Thomas and Crystal Aguh",
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T1 - Approach to treatment of refractory dissecting cellulitis of the scalp

T2 - a systematic review

AU - Thomas, Jamael

AU - Aguh, Crystal

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N2 - Background: Dissecting cellulitis is a chronic inflammatory dermatosis that results in disfiguring and painful, purulent lesions. Treatment of patients with disease resistant to standard therapies, including intralesional or topical steroids or antibiotics, can be a dilemma for clinicians. Methods: We performed a systematic review of the literature in November 2018 to find articles which presented treatment options and outcomes of patients who failed prior treatment with standard therapies. Results: We identified 57 articles of interest, with 53 being case studies or series. Isotretinoin was the most often reported, but the response was limited. Biologics and laser therapy were used less often but demonstrated a better chance of remission. X-ray epilation and surgical excision demonstrated the best remission rates but can be complicated by serious morbidity. Conclusion: We propose a regimen for the treatment of recalcitrant cases of dissecting cellulitis. In the future, more robust studies including randomized control trials are needed to identify the preferred treatment options for refractory dissecting cellulitis.

AB - Background: Dissecting cellulitis is a chronic inflammatory dermatosis that results in disfiguring and painful, purulent lesions. Treatment of patients with disease resistant to standard therapies, including intralesional or topical steroids or antibiotics, can be a dilemma for clinicians. Methods: We performed a systematic review of the literature in November 2018 to find articles which presented treatment options and outcomes of patients who failed prior treatment with standard therapies. Results: We identified 57 articles of interest, with 53 being case studies or series. Isotretinoin was the most often reported, but the response was limited. Biologics and laser therapy were used less often but demonstrated a better chance of remission. X-ray epilation and surgical excision demonstrated the best remission rates but can be complicated by serious morbidity. Conclusion: We propose a regimen for the treatment of recalcitrant cases of dissecting cellulitis. In the future, more robust studies including randomized control trials are needed to identify the preferred treatment options for refractory dissecting cellulitis.

KW - biologics

KW - Cicatricial alopecia

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KW - ethnic skin

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