Dissecting Folliculitis (Dissecting Cellulitis) of the Scalp: A 66-Patient Case Series and Proposal of Classification

In a retrospective study of 66 patients (63 men and 3 women, mean age 24.9 years) with Dissecting folliculitis (DF) of the scalp, researchers in Taiwan found that the condition was not uncommon and may be associated with obesity, as 29 of 45 patients were observed to be obese. The disease severity was linked to longer disease duration and a greater number of nodules. A complete remission rate of 25% was achieved with any treatment, and 37.5% with oral isotretinoin alone. Histopathological examination showed lymphocytes as the main inflammatory cells in the acute stage. The study proposed a classification and treatment algorithm, suggesting oral doxycycline or minocycline for mild cases and oral isotretinoin for severe cases, with additional therapies like intralesional steroid injections and short-term oral prednisolone. Surgical interventions were considered for advanced stages to prevent scarring alopecia. The findings highlighted the importance of early diagnosis and treatment to prevent scarring.