A Systematic Review of Tumor Necrosis Factor-α Blockers, Anti-Interleukins, and Small Molecule Inhibitors for Dissecting Cellulitis of the Scalp Treatment

    May 2025 in “ Orphanet Journal of Rare Diseases ”
    Nazila Heidari, Rad Ghannadzadeh Kermani Pour, Melina Farshbafnadi, Amirhossein Heidari, Yekta Ghane
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    TLDR TNF-α blockers and IL inhibitors improve symptoms in most patients with severe scalp condition, but more research is needed.
    This systematic review analyzed 34 articles involving 81 patients to evaluate the safety and efficacy of TNF-α blockers, anti-interleukins, and small molecule inhibitors for treating dissecting cellulitis of the scalp (DCS), a challenging form of scarring alopecia. The review found that TNF-α blockers and IL inhibitors showed clinical improvement in most patients with moderate-to-severe DCS, especially those unresponsive to previous treatments. Certolizumab pegol was noted as a potentially safe option during pregnancy. Small molecule inhibitors like JAK inhibitors and apremilast also demonstrated significant symptom improvement with a favorable safety profile. However, the data is limited, and further research is needed to confirm long-term safety and effectiveness, particularly regarding hair regrowth and scarring reversal.
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