There is a broader differential for other inflammatory focal alopecias including discoid lupus, lichen planopilaris, and dissecting cellulitis
of the scalp, which can have similar pus-filled lumps, and cause permanent hair loss, but may be differentiated by associated conditions such as acne conglobata, hidradenitis suppurativa, and pilonidal sinus.
Dissecting cellulitis of the scalp (DCS) is an uncommon inflammatory disease that often results in scarring alopecia.
Dissecting cellulitis of the scalp (DCS) is an uncommon chronic and relapsing inflammatory disease predominantly occurring in the scalp of young black or Hispanic men.
Follicular occlusion triad: hidradenitis suppurativa, acne conglobata, and dissecting cellulitis of the scalp.
3 Cases of Dissecting Cellulitis of the Scalp Treated With Adalimumab.
HS is associated with numerous skin diseases, especially those categorized as follicular occlusion conditions (acne conglobata, dissecting cellulitis or the scalp, and pilonidal cyst (6), (7) and acne vulgaris.
A case of dissecting cellulitis and a review of the literature.
TABLE Diseases Commonly Associated With Hidradenitis Suppurativa (1) Diseases of follicular occlusion (follicular occlusion triad) * Acne vulgaris * Acne conglobata * Dissecting cellulitis
of the scalp Pilonidal cyst Crohn's disease Obesity/metabolic syndrome
Results In our study, major causes of cicatricial alopecia were lichen planopilaris (27.5%), discoid lupus erythematosus (25%), pseudopelade of Brocq (20%), systemic lupus erythematosus (5%) followed by scleroderma, dermatomyositis, keratosis follicularis spinulosa decalvans, aplasia cutis, kerion, follicular mucinosis, pemphigus, dissecting cellulitis of scalp/ pyogenic folliculitis and acne keloidalis nuchae in 2.5% cases each.
Less frequent causes were SLE in 5% cases followed by scleroderma, dermatomyositis, keratosis follicularis spinulosa decalvans, aplasia cutis, kerion, follicular mucinosis, pemphigus, dissecting cellulitis of scalp/ pyogenic folliculitis and acne keloidalis nuchae in 2.5% cases each.
* Dissecting cellulitis of the scalp is a distinctive, often debilitating disease commonly seen in young adult African American men.
(5) Although both dissecting cellulitis and FD are considered primary neutrophilic scarring alopecias, the presence of true sinus tract formation can be a distinguishing finding.