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

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.