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

Thomas, Jamael; Aguh, Crystal

doi:10.1080/09546634.2019.1642441

Cited by 44 publications

(56 citation statements)

References 46 publications

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“…Oral isotretinoin (OI) at 1 mg/kg body weight daily for at least 6 months, in combination with systemic antibiotic, and a burst of oral prednisone at 1 mg/kg with subsequent tapering have been proposed as first-line therapy for moderate to severe disease with a high remission rate. [3][4][5][6] The mechanism of action of OI in DCS is not yet fully established, but-as in acneit appears to be related to its sebosuppressive effect, normalization of follicular keratinization, and an anti-inflammatory effect. 7 Currently there are no OI dosing or treatment duration guidelines for DCS.…”

Section: Low-dose Isotretinoin As a Therapeutic Option For Dissectingmentioning

confidence: 99%

Low‐dose isotretinoin as a therapeutic option for dissecting cellulitis

Melo

Trüeb²,

Dutra

et al. 2020

Dermatologic Therapy

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Section: Low-dose Isotretinoin As a Therapeutic Option For Dissectingmentioning

confidence: 99%

Low‐dose isotretinoin as a therapeutic option for dissecting cellulitis

Melo

Trüeb²,

Dutra

et al. 2020

Dermatologic Therapy

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“…The use of isotretinoin has been reported since the 1980s, with good results. 215 , 216 A recent SR included 182 studies and 475 patients. Among those treated with retinoids, isotretinoin led to a good response in 61%; etretinate in 47%; and acitretin in 24%.…”

Section: Results Of Studies Justifying Recommendationmentioning

confidence: 99%

Consensus on the use of oral isotretinoin in dermatology - Brazilian Society of Dermatology

Bagatin

Costa

Rocha

et al. 2020

Anais Brasileiros de Dermatologia

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Background Isotretinoin is a synthetic retinoid, derived from vitamin A, with multiple mechanisms of action and highly effective in the treatment of acne, despite common adverse events, manageable and dose-dependent. Dose-independent teratogenicity is the most serious. Therefore, off-label prescriptions require strict criteria. Objective To communicate the experience and recommendation of Brazilian dermatologists on oral use of the drug in dermatology. Methods Eight experts from five universities were appointed by the Brazilian Society of Dermatology to develop a consensus on indications for this drug. Through the adapted DELPHI methodology, relevant elements were listed and an extensive analysis of the literature was carried out. The consensus was defined with the approval of at least 70% of the experts. Results With 100% approval from the authors, there was no doubt about the efficacy of oral isotretinoin in the treatment of acne, including as an adjunct in the correction of scars. Common and manageable common adverse events are mucocutaneous in nature. Others, such as growth retardation, abnormal healing, depression, and inflammatory bowel disease have been thoroughly investigated, and there is no evidence of a causal association; they are rare, individual, and should not contraindicate the use of the drug. Regarding unapproved indications, it may represent an option in cases of refractory rosacea, severe seborrheic dermatitis, stabilization of field cancerization with advanced photoaging and, although incipient, frontal fibrosing alopecia. For keratinization disorders, acitretin performs better. In the opinion of the authors, indications for purely esthetic purposes or oil control are not recommended, particularly for women of childbearing age. Conclusions Approved and non-approved indications, efficacy and adverse effects of oral isotretinoin in dermatology were presented and critically evaluated.

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“…However, relapse was common with relapse rate of 19%. 4 The usual dose of isotretinoin is 0.5–1mg/kg, and the response is typically seen within 3 months; however, the duration of therapy is still controversial. Several antibiotics were used for our patient but with no significant improvement.…”

Section: Discussionmentioning

confidence: 99%

“…Photodynamic therapy and surgical excision have been used in resistant cases. 3 , 4 Recently, few reports have been published about the use of tumor necrosis factor (TNF-α) inhibitors in DC with promising results. 5 Herein, we report a case of recalcitrant dissecting cellulitis of the scalp successfully treated with adalimumab.…”

Section: Introductionmentioning

confidence: 99%

Recalcitrant Dissecting Cellulitis of the Scalp Treated Successfully with Adalimumab with Hair Regrowth: A Case Report

Alsantali

Almalki

Alharbi

2021

CCID

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Dissecting cellulitis (DC) of the scalp or perifolliculitis capitis abscedens et suffodiens is a rare chronic inflammatory condition of the scalp manifested by perifollicular pustules, nodules, abscesses and sinuses that result into scarring alopecia. Treatment of DC is challenging and often disappointing. We report a 38-year-old male patient with DC for 5 years, and multiple topical and systemic therapies had shown poor effect. This patient achieved excellent response to adalimumab with hair regrowth.

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

Cited by 44 publications

References 46 publications

Low‐dose isotretinoin as a therapeutic option for dissecting cellulitis

Low‐dose isotretinoin as a therapeutic option for dissecting cellulitis

Consensus on the use of oral isotretinoin in dermatology - Brazilian Society of Dermatology

Recalcitrant Dissecting Cellulitis of the Scalp Treated Successfully with Adalimumab with Hair Regrowth: A Case Report

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