Dissecting cellulitis of the scalp: response to isotretinoin

Abstract

There is only one previous case in the literature of labial ulcers occurring after topical imiquimod applications for the treatment of facial plane warts. 4 As in the present case, this event illustrates the possibility of a regional side-effect at distance from the application site. However, in contrast to our case, the lesions were apthous ulcers, and there was no background of cheilitis. To date, the individual response to imiquimod and its intensity is impossible to predict. The local as well as regional skin reaction probably depend on many factors like skin morphology, vascular anatomy, presence of pre-inflammatory conditions and level of host immune response.This observation suggests that imiquimod may enhance a distant inflammatory skin reaction in the absence of application-site effects. Because of the growing evidence of imiquimod efficacy in a variety of dermatosis and the widespread use of this topical immunostimulant, clinicians should be aware of such a potential side-effect.

Diseases of cutaneous appendages

“…449 The etiology is unknown, but follicular occlusion is presumed to play a role. 445,453,454 Quinolone antibiotics may be used as adjuvant therapy. 450,451 Harsh trauma was implicated in one case.…”

“…607 It presents with a localized area of brittle, easily broken hairs on the scalp. 454,[609][610][611] TRICHOMEGALY Trichomegaly (OMIM 190330) refers to an enlargement and hypertrichosis of the eyelashes. 454,[609][610][611] TRICHOMEGALY Trichomegaly (OMIM 190330) refers to an enlargement and hypertrichosis of the eyelashes.…”

A Review of Treatments for Dissecting Cellulitis of the Scalp

“…Isotretinoin and acitretin are used for the treatment of DCS because they reduce follicular occlusion and decrease sebaceous activity. Isotretinoin can offer good results, particularly when used early in the disease course, because of the possibility of remission within one year of therapy [21][22][23][24] . Patients in a case report and comprehensive review were able to achieve remission on monotherapy with isotretinoin doses from 0.5-1 mg/kg over 4-12 months 21,23 , although one case report added dapsone for sustained improvement 22 .…”

“…Isotretinoin can offer good results, particularly when used early in the disease course, because of the possibility of remission within one year of therapy [21][22][23][24] . Patients in a case report and comprehensive review were able to achieve remission on monotherapy with isotretinoin doses from 0.5-1 mg/kg over 4-12 months 21,23 , although one case report added dapsone for sustained improvement 22 . One case report of a 25-yearold man was administered 0.8 mg/kg isotretinoin and achieved significant clinical improvement within 4 months of treatment, with evidence of hair regrowth at 6 months.…”

Cicatricial Alopecias

“…Antibiotics such as minocycline, tetracycline, erythromycin, clindamycin along with zinc sulfate, dapsone, colchicine, corticosteroids can be recommended as other treatment options. In persistent cases, surgical interventions such as excision and grafting may be considered [73][74][75][76].…”