Approach to treatment of refractory dissecting cellulitis of the scalp: a systematic review

Jamael Thomas, Crystal Aguh

Research output: Contribution to journalReview articlepeer-review

2 Scopus citations


Background: Dissecting cellulitis is a chronic inflammatory dermatosis that results in disfiguring and painful, purulent lesions. Treatment of patients with disease resistant to standard therapies, including intralesional or topical steroids or antibiotics, can be a dilemma for clinicians. Methods: We performed a systematic review of the literature in November 2018 to find articles which presented treatment options and outcomes of patients who failed prior treatment with standard therapies. Results: We identified 57 articles of interest, with 53 being case studies or series. Isotretinoin was the most often reported, but the response was limited. Biologics and laser therapy were used less often but demonstrated a better chance of remission. X-ray epilation and surgical excision demonstrated the best remission rates but can be complicated by serious morbidity. Conclusion: We propose a regimen for the treatment of recalcitrant cases of dissecting cellulitis. In the future, more robust studies including randomized control trials are needed to identify the preferred treatment options for refractory dissecting cellulitis.

Original languageEnglish (US)
Pages (from-to)144-149
Number of pages6
JournalJournal of Dermatological Treatment
Issue number2
StatePublished - 2021


  • Cicatricial alopecia
  • X-ray epilation
  • biologics
  • dissecting cellulitis
  • ethnic skin
  • laser
  • perifolliculitis capitis abscedens
  • refractory
  • scarring alopecia
  • skin of color
  • steroids
  • surgery
  • treatment

ASJC Scopus subject areas

  • Dermatology


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