perifolliculitis capitis abscedens et suffodiens; dissecting cellulitis

Etiology

• idiopathic

Epidemiology

• occurs predominantly in black males in their second to fourth decade of life
• occurs less commonly in women & persons of different race

Pathology

• follicular occlusion
• dissecting cellulitis of the scalp
• draining nodules & sinus tracts

Clinical manifestations

• perifollicular pustules, nodules, & subsutaneous abscesses withinterconnecting sinus tracts that drain pus or blood
• chronic course
• unpredictable relapses
• spontaneous resolution may occur

* image

Laboratory

• bacterial cultures of purulent discharge

Complications

• leads to cicatricial alopecia

Differential diagnosis

• kerion
• furunculosis
• hydradenitis suppurativa

Management

• oral isotretinoin may be the treatment of choice
• oral acitretin & alitretinoin have also been used
• intralesional corticosteroids to decrease inflammation with short-lived benefit

More general terms

• chronic skin disease

Additional terms

• cellulitis
• folliculitis