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Hajizadeh N, Heidari A, Sadeghi S, Goodarzi A. Tumor necrosis factor inhibitors and janus kinase inhibitors in the treatment of cicatricial alopecia: A systematic review. PLoS One 2024; 19:e0293433. [PMID: 38335182 PMCID: PMC10857607 DOI: 10.1371/journal.pone.0293433] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2023] [Accepted: 10/12/2023] [Indexed: 02/12/2024] Open
Abstract
BACKGROUND Cicatricial alopecia (CA) refers to various conditions that result in permanent hair loss. Treatment of CA has always been challenging. Regarding immune-mediated pathophysiology for many CA subtypes, the administration of Janus kinase (JAK) and tumor necrosis factor (TNF) inhibitors have potentiated the treatments of CA. METHODS After a thorough systematic search in PubMed/Medline, Embase, Web of Science, Scopus, Google Scholar, ClinicalTrials.gov, and WHO ICTRP, a total of 3,532 relevant records were retrieved and screened. Accordingly, 56 studies met the eligibility criteria and entered the review. RESULTS Among JAK inhibitors, oral tofacitinib was the most frequently reported and the most effective treatment in improving signs and symptoms of CA with minimal adverse effects (AEs). Baricitinib was another JAK inhibitor with sustained improvement while causing mild AEs. As a TNF inhibitor, adalimumab induced a rapid and stable improvement in signs and symptoms in most patients with rare, tolerable AEs. Thalidomide was the other frequently reported yet controversial TNF inhibitor, which caused a rapid and significant improvement in the condition. However, it may result in mild to severe AEs, particularly neuropathies. Infliximab is a TNF inhibitor with mostly favorable results, albeit in a few patients caused treatable dermatological AEs. Apremilast and certolizumab pegol caused an incomplete amelioration of signs and symptoms with no AEs. Lenalidomide is another TNF inhibitor that can induce temporary improvement in CA with probable AEs. It is noteworthy that utilizing adalimumab, infliximab, etanercept, golimumab, and an anonymous TNF inhibitor has induced paradoxical CA and other A.E.s in some patients. CONCLUSION Recent studies have recommended JAK and TNF inhibitors, especially oral tofacitinib and adalimumab, as a new modality or adjuvant therapy to previous medications for primary CA. Nonetheless, monitoring AEs on a regular basis is suggested, and further extensive studies are required before definitive recommendations.
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Affiliation(s)
- Nima Hajizadeh
- School of Medicine, Iran University of Medical Sciences, Tehran, Iran
- Rasool Akram Medical Complex Clinical Research Development Center (RCRDC), Iran University of Medical Sciences, Tehran, Iran
| | - Amirhossein Heidari
- Faculty of Medicine, Tehran Medical Sciences, Islamic Azad University, Tehran, Iran
| | - Sara Sadeghi
- Rasool Akram Medical Complex Clinical Research Development Center (RCRDC), Iran University of Medical Sciences, Tehran, Iran
- Department of Medicine, New York Health System, South Brooklyn Hospital, New York, NY, United States of America
| | - Azadeh Goodarzi
- Rasool Akram Medical Complex Clinical Research Development Center (RCRDC), Iran University of Medical Sciences, Tehran, Iran
- Department of Dermatology, Faculty of Dermatology, Rasool Akram Medical Complex Clinical Research Development Center (RCRDC), School of Medicine, Iran University of Medical Sciences, Tehran, Iran
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Miura S, Tsunoda K, Amano H. A case of perifolliculitis capitis abscedens et suffodiens and acne conglobata effectively treated with a tumor necrosis factor α inhibitor. Dermatol Reports 2023; 15:9699. [PMID: 37908605 PMCID: PMC10614559 DOI: 10.4081/dr.2023.9699] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2023] [Accepted: 02/24/2023] [Indexed: 11/02/2023] Open
Abstract
Perifolliculitis capitis abscedens et suffodiens (PCAS) and acne conglobate (AC) are often treated with isotretinoin and tumor necrosis factor alpha (TNF-α) inhibitors in Europe and the United States. Treatment with these drugs is uncommon in Asia, and alternative treatment options are limited. In this paper, we report the case of a Japanese patient who presented with PCAS and AC and was treated successfully with adalimumab.
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Affiliation(s)
- Shinpei Miura
- Department of Dermatology, School of Medicine, Iwate Medical University, Shiwa-gun, Iwate, Japan
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3
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Jastrząb B, Szepietowski JC, Matusiak Ł. Hidradenitis suppurativa and follicular occlusion syndrome: Where is the pathogenetic link? Clin Dermatol 2023; 41:576-583. [PMID: 37690621 DOI: 10.1016/j.clindermatol.2023.08.021] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/12/2023]
Abstract
The follicular occlusion tetrad complex encompasses several entities (hidradenitis suppurativa, acne conglobata, dissecting cellulitis of the scalp, and pilonidal cyst) that share common clinical features, risk factors, and pathophysiology. Follicular occlusion is a crucial triggering mechanism in the etiology in each of these disorders, leading to development of distinctive skin lesions such as deep-seated nodules, abscesses, comedones, and draining sinuses, often with accompanying scarring. Despite the fact that the follicular occlusion tetrad components manifest multiple similarities, they also exhibit many differences among themselves and require individual approaches and treatment.
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Affiliation(s)
- Beata Jastrząb
- Department of Dermatology, Venereology, and Allergology, Wroclaw Medical University, Wroclaw, Poland
| | - Jacek C Szepietowski
- Department of Dermatology, Venereology, and Allergology, Wroclaw Medical University, Wroclaw, Poland.
| | - Łukasz Matusiak
- Department of Dermatology, Venereology, and Allergology, Wroclaw Medical University, Wroclaw, Poland
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Yu Y, Ding X, Guo F, Ze K, Sun X, Li X. Perifolliculitis capitis abscedens et suffodiens treatment with tumor necrosis factor inhibitors and baricitinib: A case report and literature review. Front Med (Lausanne) 2023; 10:1132574. [PMID: 37056728 PMCID: PMC10086126 DOI: 10.3389/fmed.2023.1132574] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/27/2022] [Accepted: 03/06/2023] [Indexed: 03/30/2023] Open
Abstract
RationalePerifolliculitis capitis abscedens et suffodiens (PCAS), also known as dissecting cellulitis of the scalp (DCS), is a part of the “follicular occlusion tetrad” that also includes acne conglobate (AC), hidradenitis suppurativa (HS), and pilonidal sinus, which share the same pathogenic mechanism, such as follicular occlusions, follicular ruptures, and follicular infections.Patient concernsA 15-year-old boy had multiple rashes on the scalp accompanied by pain.DiagnosisThe patient was diagnosed with PCAS or DCS based on the clinical manifestations and laboratory examinations.InterventionsThe patient was initially administered adalimumab 40 mg biweekly and oral isotretinoin 30 mg daily for 5 months. Because the initial results were insufficient, the interval between adalimumab injections was extended to 4 weeks, and isotretinoin was changed to baricitinib 4 mg daily for 2 months. When the condition became more stable, adalimumab 40 mg and baricitinib 4 mg were administered every 20 and 3 days, respectively, for two more months until now.OutcomesAfter 9 months of treatment and follow-up, the original skin lesions of the patient were almost cured, and most inflammatory alopecia patches disappeared.ConclusionOur literature review did not find any previous reports on treating PCAS with TNF-α inhibitors and baricitinib. Accordingly, we presented the first successful treatment of PCAS with this regimen.
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Affiliation(s)
- Yuanting Yu
- Department of Dermatology, Yueyang Hospital of Integrated Traditional Chinese and Western Medicine, Shanghai University of Traditional Chinese Medicine, Shanghai, China
- Institute of Dermatology, Shanghai Academy of Traditional Chinese Medicine, Shanghai, China
| | - Xiaojie Ding
- Department of Dermatology, Yueyang Hospital of Integrated Traditional Chinese and Western Medicine, Shanghai University of Traditional Chinese Medicine, Shanghai, China
| | - Fei Guo
- Department of Dermatology, Yueyang Hospital of Integrated Traditional Chinese and Western Medicine, Shanghai University of Traditional Chinese Medicine, Shanghai, China
| | - Kan Ze
- Department of Dermatology, Yueyang Hospital of Integrated Traditional Chinese and Western Medicine, Shanghai University of Traditional Chinese Medicine, Shanghai, China
| | - Xiaoying Sun
- Department of Dermatology, Yueyang Hospital of Integrated Traditional Chinese and Western Medicine, Shanghai University of Traditional Chinese Medicine, Shanghai, China
- Institute of Dermatology, Shanghai Academy of Traditional Chinese Medicine, Shanghai, China
- Xiaoying Sun,
| | - Xin Li
- Department of Dermatology, Yueyang Hospital of Integrated Traditional Chinese and Western Medicine, Shanghai University of Traditional Chinese Medicine, Shanghai, China
- Institute of Dermatology, Shanghai Academy of Traditional Chinese Medicine, Shanghai, China
- *Correspondence: Xin Li,
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Xu M, Yan J. 2940-nm multifractional erbium:yttrium-aluminum-garnet laser for the treatment of dissecting cellulitis of the scalp: Case reports and literature review. J Dermatol 2022; 49:e230-e231. [PMID: 35318708 DOI: 10.1111/1346-8138.16344] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/05/2022] [Revised: 02/10/2022] [Accepted: 02/21/2022] [Indexed: 11/28/2022]
Affiliation(s)
- Mengjun Xu
- Department of Dermatology, Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, China
| | - Jianliang Yan
- Department of Dermatology, Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, China
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He J, Yang Y, Jin L, Li S, Xie F, Fan J, Li C. 20% ALA-PDT pretreated by fire needle in patients with dissecting cellulitis of the scalp: An interim analysis. Photodiagnosis Photodyn Ther 2021; 36:102544. [PMID: 34551324 DOI: 10.1016/j.pdpdt.2021.102544] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/26/2021] [Revised: 09/14/2021] [Accepted: 09/17/2021] [Indexed: 11/26/2022]
Abstract
BACKGROUND Dissecting cellulitis of the scalp (DCS) is a rare but distinctive, chronic suppurative condition, and the treatment is a therapeutic challenge. Recently, treatment of DCS with 5-aminolaevulinic acid photodynamic therapy (ALA-PDT) has been considered as a potential option. OBJECTIVE To evaluate the efficacy and safety of 20% ALA-PDT pretreated by fire needle in the treatment of DCS. MATERIALS AND METHODS Topical 20% ALA-PDT with fire needle intervention as a pretreatment, was applied to six patients with DCS. All patients completed three sessions treatment at an interval of ten days. They were assessed for the efficacy at the baseline and on ten days after each treatment. According to the reduction of lesions and the improvements of patients' symptoms after each session, the objective assessment of therapeutic effect was divided into four grades. The adverse effects were recorded. RESULTS A total of six male patients were enrolled in our study. After three sessions of ALA-PDT, among them, three patients recovered, two patients achieved significant improvement and one patient achieved partial response.Patient 4 (Pt.4) relapsed at 6-month follow-up. Pt.1 and Pt.6. maintained complete response after one year follow-up. We also found that the clearance rate of the popular/nodular and cyst/abscess was much higher than sinus. CONCLUSION 20% ALA-PDT pretreated by fire needle could be an effective, minimally-invasive, safe method for DCS patients. Lesion in the early stages have a better response than sinus.
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Affiliation(s)
- Juan He
- Department of Dermatology, First Medical Center of Chinese PLA General Hospital, Beijing, 100853, China; Medical College of Nankai University, Tianjin, 300071, China
| | - Yi Yang
- Department of Dermatology, First Medical Center of Chinese PLA General Hospital, Beijing, 100853, China
| | - Liang Jin
- Department of Dermatology, Air Force Medical Center, PLA, Beijing 100142, China
| | - Shan Li
- Department of Dermatology, First Medical Center of Chinese PLA General Hospital, Beijing, 100853, China
| | - Fang Xie
- Department of Dermatology, First Medical Center of Chinese PLA General Hospital, Beijing, 100853, China
| | - Jianfeng Fan
- Department of Dermatology, First Medical Center of Chinese PLA General Hospital, Beijing, 100853, China
| | - Chengxin Li
- Department of Dermatology, First Medical Center of Chinese PLA General Hospital, Beijing, 100853, China.
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Federico A, Rossi A, Caro G, Magri F, Muscianese M, Di Fraia M, Carlesimo M. Are dissecting cellulitis and hidradenitis suppurativa different diseases? Clin Dermatol 2021; 39:496-499. [PMID: 34518010 DOI: 10.1016/j.clindermatol.2021.01.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Abstract
Although dissecting cellulitis (DC) and hidradenitis suppurativa (HS) are classified separately, they share many clinical, dermatoscopic, pathogenetic, and histologic aspects, as well as therapeutic options. The association between DC, HS, and acne conglobata represents the follicular occlusion triad or follicular occlusion tetrad, which may include a pilonidal sinus. DC, also known as "folliculitis et perifolliculitis capitis abscendes et suffoidens," is classified as a secondary cicatricial and neutrophilic alopecia. It occurs with perifolliculitis of the scalp, dermal abscesses, sinus tract development, and secondary scarring alopecia. HS, sometimes known as acne inversa, is a chronic relapsing inflammatory disease afflicting apocrine gland-rich areas of the body with painful nodules and abscesses, sinus tracts, and scarring. Given the overlap between the clinical features and the pathogenesis of DC and HS, it would be more appropriate to consider these conditions as two different localizations of the same disease rather than two different pathologies, being a follicular occlusion disease occurring on the scalp and on the apocrine gland-rich areas of the body.
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Affiliation(s)
- Alessandro Federico
- Dermatology Unit, Department of Clinical Internal, Anesthesiological and Cardiovascular Sciences, Sapienza University of Rome, Rome, Italy.
| | - Alfredo Rossi
- Dermatology Unit, Department of Clinical Internal, Anesthesiological and Cardiovascular Sciences, Sapienza University of Rome, Rome, Italy
| | - Gemma Caro
- Dermatology Unit, Department of Clinical Internal, Anesthesiological and Cardiovascular Sciences, Sapienza University of Rome, Rome, Italy
| | - Francesca Magri
- Dermatology Unit, Department of Clinical Internal, Anesthesiological and Cardiovascular Sciences, Sapienza University of Rome, Rome, Italy
| | - Marta Muscianese
- Dermatology Unit, Department of Clinical Internal, Anesthesiological and Cardiovascular Sciences, Sapienza University of Rome, Rome, Italy
| | - Marco Di Fraia
- Dermatology Unit, Department of Clinical Internal, Anesthesiological and Cardiovascular Sciences, Sapienza University of Rome, Rome, Italy
| | - Marta Carlesimo
- Dermatology Unit, Department of Clinical Internal, Anesthesiological and Cardiovascular Sciences, Sapienza University of Rome, Rome, Italy
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Wu HE, Liu YB, Cui L, Xu GJ, Sun XD. A prospective study of the effect of fire micro-needling plus 5% topical ALA-PDT for the treatment of dissecting cellulitis of the scalp. Photodiagnosis Photodyn Ther 2021; 35:102396. [PMID: 34133960 DOI: 10.1016/j.pdpdt.2021.102396] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/09/2020] [Revised: 04/30/2021] [Accepted: 05/03/2021] [Indexed: 11/26/2022]
Abstract
BACKGROUND Different therapies have been used for dissecting cellulitis of the scalp (DCS) with poor results. Topical 5-aminolaevulinic acid photodynamic therapy (ALA-PDT) is effective for many inflammatory skin diseases. OBJECTIVES To evaluate the efficacy and safety of fire micro-needling plus 5% ALA-PDT on DCS. METHODS Forty-two male DCS patients were enrolled and treated by four sessions of fire micro-needling plus 5% ALA-PDT (occlusion time: 3 h, 100 mW/cm2 for 20-32 min, 633 ± 10 nm LED) with an interval of 1-2 weeks. The reduction of lesions was evaluated at each follow-up visit. The patients` symptoms were evaluated by Dermatology Life Quality Index (DLQI). All of the side effects were recorded. RESULTS Forty-one DCS patients finished the treatments and the marked effective rate (MER) reached 65.85%. Ten patients (24.39%) were cured and 17 patients (41.46%) achieved excellent improvement. The median of lesion numbers decreased significantly from 25 to 7 (p < 0.001) with DLQI from 13 to 2 (p < 0.001). Although all the ten cured patients had a relapse during the 12-month follow-up, 5/10 patients had a remission of more than 6 months. All the patients tolerated PDT well with mild adverse effects. CONCLUSIONS Fire micro-needling plus 5% ALA-PDT is effective for Chinese male DCS patients without the need to take systemic drugs.
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Affiliation(s)
- Hai En Wu
- Department of Dermatology, the Seventh People`s Hospital of Shenyang, Shenyang, 110003, China.
| | - Yong Bin Liu
- Department of Dermatology, the Seventh People`s Hospital of Shenyang, Shenyang, 110003, China.
| | - Liang Cui
- Department of Dermatology, the Seventh People`s Hospital of Shenyang, Shenyang, 110003, China.
| | - Gui Juan Xu
- Department of Cardiology, the Seventh People`s Hospital of Shenyang, Shenyang, 110003, China
| | - Xiao Dong Sun
- Department of Dermatology, the Seventh People`s Hospital of Shenyang, Shenyang, 110003, China
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Baneu NS, Bloancă VA, Szilagyi D, Cristodor P, Pesecan A, Bratu TI, Crăiniceanu ZP. Surgical management of dissecting cellulitis of the scalp using free latissimus dorsi flap and meshed split-thickness skin graft: A case report. Medicine (Baltimore) 2021; 100:e24092. [PMID: 33530203 PMCID: PMC7850723 DOI: 10.1097/md.0000000000024092] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/31/2020] [Accepted: 12/08/2021] [Indexed: 01/05/2023] Open
Abstract
INTRODUCTION Dissecting cellulitis of the scalp, or Hoffman disease, is described as an extremely rare condition. Clinically, it is represented by recurrent painful nodules, purulent drainage, interconnected sinus tracts and keloid formation, leading to scaring and cicatricial alopecia. Without a precise diagnosis and an adequate treatment, the repercussions consist of severe infectious complications along with psychological negative effects and serious aesthetic alterations. There is no standard treatment. In refractory cases, surgical management is reported. PATIENT CONCERNS We report a case of a 65-year-old Caucasian male patient, with a 5-year history of Hoffman disease, who presented with multiple abscesses and sinus tracts of the scalp and patches of alopecia. The lesions were non-responsive to medical treatment. DIAGNOSIS The diagnosis of DCS has been established on the basis of the clinical appearance and has been confirmed histopathologically. INTERVENTIONS The patient underwent wide excision of the scalp, followed by reconstruction using free latissimus dorsi flap and covered by meshed split-thickness skin graft. OUTCOMES Eighteen-month follow-up revealed complete remission of symptoms and lesions along with satisfactory cosmetic result. CONCLUSION The scope of this case report is to raise awareness of the following aspects: Hoffman disease has an extremely low occurrence rate, a difficult differential diagnosis and no standard therapeutical strategy. It also highlights the effectiveness of scalpectomy and free latissimus dorsi flap covered by meshed split-thickness skin graft in treating a very advanced stage of the disease together with providing a natural contouring of the scalp. Ultimately, it discusses the other treatment alternatives.
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Affiliation(s)
- Nicoleta-Sara Baneu
- “Pius Brînzeu” Emergency County Hospital Timişoara, Department of Plastic and Reconstructive Surgery
| | - Vlad Adam Bloancă
- “Pius Brînzeu” Emergency County Hospital Timişoara, Department of Plastic and Reconstructive Surgery
- “Victor Babeş” University of Medicine and Pharmacy, Faculty of Medicine
| | - Diana Szilagyi
- “Pius Brînzeu” Emergency County Hospital Timişoara, Department of Pathology
| | - Patricia Cristodor
- “Victor Babeş” University of Medicine and Pharmacy, Faculty of Medicine
- Emergency Clinical Municipal Hospital, Timişoara, Department of Dermatology, Romania
| | - Alexandru Pesecan
- “Pius Brînzeu” Emergency County Hospital Timişoara, Department of Plastic and Reconstructive Surgery
| | - Tiberiu Ioan Bratu
- “Pius Brînzeu” Emergency County Hospital Timişoara, Department of Plastic and Reconstructive Surgery
- “Victor Babeş” University of Medicine and Pharmacy, Faculty of Medicine
| | - Zorin Petrişor Crăiniceanu
- “Pius Brînzeu” Emergency County Hospital Timişoara, Department of Plastic and Reconstructive Surgery
- “Victor Babeş” University of Medicine and Pharmacy, Faculty of Medicine
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Guo W, Zhu C, Stevens G, Silverstein D. Analyzing the Efficacy of Isotretinoin in Treating Dissecting Cellulitis: A Literature Review and Meta-Analysis. Drugs R D 2021; 21:29-37. [PMID: 33387328 PMCID: PMC7937584 DOI: 10.1007/s40268-020-00335-y] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/15/2020] [Indexed: 11/27/2022] Open
Abstract
BACKGROUND AND OBJECTIVE Dissecting cellulitis of the scalp is a primary scarring alopecia. Isotretinoin is commonly referenced in the literature as a treatment for dissecting cellulitis. The objective of this article was to conduct a review and meta-analysis to assess the efficacy of isotretinoin for treating dissecting cellulitis of the scalp. METHODS The following databases were searched for articles prior to 23 June, 2019: PubMed, Embase, Cochrane Central, CINAHL, and Web of Science. Multi-patient studies (more than three) that reported on the administration of isotretinoin for dissecting cellulitis were included. A pooled meta-analysis for improvement of disease burden after isotretinoin administration in patients with dissecting cellulitis of the scalp was performed. A fixed-effects model was used. RESULTS Five articles were ultimately used for the quantitative meta-analysis. The overall efficacy rate of isotretinoin in treating dissecting cellulitis of the scalp was estimated to be 0.9 with a 95% confidence interval (0.81-0.97). The sensitivity analysis suggested that the overall efficacy is still very high, with a range of 0.83-0.94. Recurrence was seen in 24% (6/25) of patients. Common associated diseases amongst patients with dissecting cellulitis of the scalp were acne conglobata 20% (30/151) and hidradenitis suppurativa 19% (11/72). CONCLUSIONS Isotretinoin is an effective treatment for improving symptoms of dissecting cellulitis of the scalp. Disease recurrence is a common finding for those who undergo successful treatment.
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Affiliation(s)
- William Guo
- Renaissance School of Medicine at Stony Brook University, 1320 Stony Brook Rd., Building F, Suite 200, Stony Brook, NY, 11790, USA.
| | - Chencan Zhu
- Department of Applied Mathematics and Statistics, Stony Brook University, Stony Brook, NY, USA
| | - Gregg Stevens
- Health Sciences Library at Stony Brook University, Stony Brook, NY, USA
| | - David Silverstein
- Department of Dermatology, Renaissance School of Medicine at Stony Brook University, Stony Brook, NY, USA
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11
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Dissecting Cellulitis of the Scalp: A Review and Case Studies of Surgical Reconstruction. PLASTIC AND RECONSTRUCTIVE SURGERY-GLOBAL OPEN 2020; 8:e3015. [PMID: 32983774 PMCID: PMC7489594 DOI: 10.1097/gox.0000000000003015] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/23/2019] [Accepted: 06/08/2020] [Indexed: 11/25/2022]
Abstract
Dissecting cellulitis of the scalp (DCS) is a part of the follicular occlusion tetrad (hidradenitis, acne conglobata, and pilonidal disease). It is a spectrum disorder that can be severe and refractory to medical management. The authors describe 3 such cases successfully treated with surgical resection and reconstruction and present a scoring system for timely referral of such patients to a reconstructive surgical team.
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12
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Navarro‐Triviño FJ, Almazán‐Fernández FM, Ródenas‐Herranz T, Ruiz‐Villaverde R. Dissecting cellulitis of the scalp successfully treated with topical resorcinol 15%. Dermatol Ther 2020; 33:e13406. [DOI: 10.1111/dth.13406] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2020] [Revised: 04/08/2020] [Accepted: 04/11/2020] [Indexed: 11/30/2022]
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13
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Maxon E, Modlin K, Durso TA, Miletta NR. A Case Report of Tumor Necrosis Factor Alpha Inhibitors in an Active Duty Service Member with Dissecting Cellulitis of the Scalp Resistant to Treatment. Mil Med 2019; 185:e1309-e1311. [DOI: 10.1093/milmed/usz394] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/04/2019] [Revised: 08/26/2019] [Indexed: 11/14/2022] Open
Abstract
ABSTRACT
Dissecting cellulitis of the scalp represents a disease of follicular occlusion that may be worsened by tight-fitting clothing, such as the patrol cap or advanced combat helmet used by military service members. Treatment poses a challenge to the clinician, and the treatment of choice, oral retinoids, may not improve the condition sufficiently to maintain active duty status. Early treatment augmentation with tumor necrosis factor-alpha inhibitors may improve efficacy of oral retinoids and prevent medical separation of the active duty service member.
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Affiliation(s)
- Emily Maxon
- San Antonio Military Health System, 3551 Roger Brooke Drive, San Antonio, TX 78234
| | - Katy Modlin
- Department of Dermatology, San Antonio Military Health System, 2200 Bergquist Drive, San Antonio, TX 78236
| | - Timothy A Durso
- Department of Dermatology, San Antonio Military Health System, 2200 Bergquist Drive, San Antonio, TX 78236
| | - Nathanial R Miletta
- Department of Dermatology, San Antonio Military Health System Laser Surgery and Scar Center, 2200 Bergquist Drive, San Antonio, TX 78236
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14
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Thomas J, Aguh C. Approach to treatment of refractory dissecting cellulitis of the scalp: a systematic review. J DERMATOL TREAT 2019; 32:144-149. [DOI: 10.1080/09546634.2019.1642441] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Affiliation(s)
- Jamael Thomas
- School of Medicine, University of Texas Southwestern Medical Center, Dallas, TX, USA
| | - Crystal Aguh
- Department of Dermatology, Johns Hopkins School of Medicine, Baltimore, MD, USA
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15
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Takahashi T, Yamasaki K, Terui H, Omori R, Tsuchiyama K, Fujimura T, Aiba S. Perifolliculitis capitis abscedens et suffodiens treatment with tumor necrosis factor inhibitors: A case report and review of published cases. J Dermatol 2019; 46:802-807. [PMID: 31271451 DOI: 10.1111/1346-8138.14998] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2019] [Accepted: 06/02/2019] [Indexed: 12/13/2022]
Abstract
Perifolliculitis capitis abscedens et suffodiens (PCAS) or dissecting cellulitis is a rare condition presenting deep follicular occlusions, follicular ruptures and follicular infections in the scalp area with unknown etiology, which consequently cause primary neutrophilic cicatricial alopecia by the repeated follicular inflammation. PCAS is categorized as one of the "follicular occlusion tetrad" along with hidradenitis suppurativa, acne conglobata and pilonidal cyst. In the pathogenesis of the follicular occlusion tetrad, the involvement of neutrophils and its activator tumor necrosis factor (TNF) have been discussed. Here, we report a case of PCAS that was successfully treated with adalimumab, a human anti-TNF monoclonal antibody. This is the first Asian case of PCAS that was improved by a TNF inhibitor.
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Affiliation(s)
- Toshiya Takahashi
- Department of Dermatology, Tohoku University Graduate School of Medicine, Sendai, Japan
| | - Kenshi Yamasaki
- Department of Dermatology, Tohoku University Graduate School of Medicine, Sendai, Japan
| | - Hitoshi Terui
- Department of Dermatology, Tohoku University Graduate School of Medicine, Sendai, Japan
| | - Ryoko Omori
- Department of Dermatology, Tohoku University Graduate School of Medicine, Sendai, Japan
| | - Kenichiro Tsuchiyama
- Department of Dermatology, Tohoku University Graduate School of Medicine, Sendai, Japan
| | - Taku Fujimura
- Department of Dermatology, Tohoku University Graduate School of Medicine, Sendai, Japan
| | - Setsuya Aiba
- Department of Dermatology, Tohoku University Graduate School of Medicine, Sendai, Japan
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16
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Feng Y, Zhang Y, Guo H, Lin Z, Chen H, Wu Y, Gao X, Chen H. Treatment of dissecting cellulitis of the scalp with 10% ALA‐PDT. Lasers Surg Med 2018; 51:332-338. [PMID: 30136732 DOI: 10.1002/lsm.23016] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/06/2018] [Indexed: 01/02/2023]
Affiliation(s)
- Yuxin Feng
- Department of DermatologyThe First Hospital of China Medical UniversityShenyangChina
| | - Yuhui Zhang
- Department of DermatologyThe First Hospital of China Medical UniversityShenyangChina
| | - Hongzuo Guo
- Department of DermatologyThe First Hospital of China Medical UniversityShenyangChina
| | - Zheng Lin
- Department of DermatologyThe First Hospital of China Medical UniversityShenyangChina
| | - Hongqiang Chen
- Department of General SurgeryShandong Qianfoshan HospitalJinanChina
| | - Yan Wu
- Department of DermatologyThe First Hospital of China Medical UniversityShenyangChina
| | - Xing‐Hua Gao
- Department of DermatologyThe First Hospital of China Medical UniversityShenyangChina
| | - Hong‐Duo Chen
- Department of DermatologyThe First Hospital of China Medical UniversityShenyangChina
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