Presentation
An eight-year-old Ethiopian male child, resident in Khartoum, Sudan presented with tender progressing fluctuant nodules and alopecia on his scalp for nine months. The lesions often oozed a serosanguinous discharge and occasionally bled. [khartoumspace.uofk.edu]
This condition often presents in males of African American origin. This article describes the clinical presentation, diagnosis, and treatment of an Aboriginal Canadian male suffering from PCAS. [ncbi.nlm.nih.gov]
A healthy 19-year-old male presented with a solitary, soft, alopecic nodule that had appeared 1 year before. [ijtrichology.com]
At present, this condition is defined as a primary disorder of follicular keratinization, being part of the triad or tetrad of follicular occlusion. One third of the cases are associated with acne conglobata as a primary event. [colombiamedica.univalle.edu.co]
Entire Body System
- Fever
Systemic symptoms also occur and include osteolytic bone lesions of the clavicle and sternum, fever, arthralgias, myalgias, and hepatosplenomegaly. Diagnosis is clinical. [accessemergencymedicine.mhmedical.com]
Here is the patient's anamnesis: July '06 Mono like illness-- severe fatigue, prolonged diarrhea (lost 30 pounds), upper abdominal pain, swollen neck lymph nodes, fever, folliculitis breakouts on face and back. [vgrd.org]
Psychogenic excoriation 651 205 Pyoderma gangrenosum 654 206 Pyogenic granuloma 659 207 Radiation dermatitis 662 208 Raynaud disease and phenomenon 665 209 Reactive arthritis 669 210 Relapsing polychondritis 673 211 Rhinophyma 677 212 Rocky Mountain spotted fever [books.google.com]
Less commonly, tender lymph nodes and/or fever may occur. The condition is usually diagnosed by a dermatologist after examination of your scalp, but in some cases, a biopsy under local anesthesia may be required for confirmation. [skinofcolorsociety.org]
- Swelling
I applied it as needed, especially when the swelling got worse. [tuftedfolliculitis.com]
Following blockage, material accumulates in the follicle, causing swelling and rupture. [skinofcolorsociety.org]
The patient referred occasional swelling, pain, and purulent discharge. On the physical examination, a soft alopecic and minimally raised nodule was found, without discharge or a distinguishable central ostium [Figure 1]. [ijtrichology.com]
Because of persistent swelling, the left arm was rebiopsied 9 months later, and a diagnosis of ENKL developing in the subcutis was established. [read.qxmd.com]
- Lymphadenopathy
Regional lymphadenopathy is rarely noted. Spondyloarthropathy has been reported in patients with PCAS [8, 9]. The cause is not known. [article.sapub.org]
Lymphadenopathy was absent. The remainder of the physical exam was unremarkable. [priory.com]
No systemic symptoms are usually evident; however, there may be cervical lymphadenopathy on examination. [medscape.com]
Cervical or occipital lymphadenopathy (chronic, abnormal enlargement of the lymph nodes) may be present. [keratin.com]
Kerion is characterized by regional lymphadenopathy and positive fungal culture which are not found in PCAS. Folliculitis decalvans shows central scarred patches of alopecia without pustules and sinuses which are characteristic of PCAS. [ijtrichology.com]
- Lymphedema
(BCRL) among working-age women, the incidence of lymphedema, and associated risk factors. [read.qxmd.com]
135 Livedoid vasculopathy 414 136 Lyme borreliosis 417 137 Lymphangioma circumscriptum 420 138 Lymphedema 423 139 Lymphocytoma cutis 425 140 Lymphogranuloma venereum 428 141 Lymphomatoid papulosis 430 142 Malignant atrophic papulosis 435 143 Malignant [books.google.com]
[…] patients with dissecting cellulitis of the scalp: A retrospective study. 62 Feng H...Jin H 33962059 2021 22 The role of biologic treatment in special scenarios in hidradenitis suppurativa: Facial and nape phenotype, dissecting cellulitis of the scalp, and lymphedema [malacards.org]
- Malaise
Regional lymphadenopathy, fever and malaise may be associated features. [docksci.com]
Skin
- Alopecia
It is an inflammatory condition of the scalp that can lead to scarring alopecia, which begins with deep inflammatory nodules, primarily over occiput, that progresses to coalescing regions of boggy scalp. [khartoumspace.uofk.edu]
[…] dissecting folliculitis of the scalp, perifolliculitis capitis abscedens et suffodiens of Hoffman, perifolliculitis abscedens et suffodiens, or folliculitis abscedens et suffodiens, is an inflammatory condition of the scalp that can lead to scarring alopecia [wikiwand.com]
Scarring alopecia or cicatricial alopecia results from follicular damage that is sufficient to cause the destruction and replacement of pilosebaceous structures by scar tissue. [pubfacts.com]
The subsequent scarring alopecia results in permanent, patchy hair loss. [dermnetnz.org]
Perifolliculitis capitis abscedens et suffodiens (also known as "Perifolliculitis capitis abscedens et suffodiens of Hoffman," "Dissecting folliculitis," and "Dissecting cellulitis of the scalp") is an inflammatory condition of the scalp that can lead to scarring alopecia [wiki30.com]
Workup
Serum
- Neutrophilia
The hemogram revealed leukocytosis with neutrophilia, C-reactive protein elevated 100 times the reference value, the rheumatoid factor, VDRL and HIV were negative. [go.gale.com]
Microbiology
- Gram-Positive Bacteria
These lesions frequently become secondarily infected with gram-positive bacteria and often heal with scarring. Pathology usually reveals inflammatory infiltrate around follicles, which can often disrupt the normal dermal architecture. [idoj.in]
Laboratory
- Leukocytosis
The hemogram revealed leukocytosis with neutrophilia, C-reactive protein elevated 100 times the reference value, the rheumatoid factor, VDRL and HIV were negative. [go.gale.com]
These lesions may be accompanied by fever, leukocytosis, and occipital adenopathy. 6 Folliculitis, which is an inflammation of the hair follicle, is characterized by dome-shaped pustules surrounded by a small area of erythema arising in the center of [aafp.org]
The hemogram revealed a raised total leukocyte count of 14,000/cmm with polymorphonuclear leukocytosis of 78%. Other investigations such as urine, blood sugar level, renal function tests, and liver function tests were within normal limits. [ijtrichology.com]
Hemogram revealed normocytic, normochromic anemia, lymphocytopenia and leukocytosis. Urine microscopy was insignificant. Liver function tests and renal function tests were within normal limits and so was FBS, PPBS and fasting lipid profile. [idoj.in]
Treatment
Isotretinoin proves to be the medicine of choice for the treatment of the disease. [1] [2] : 649 [3] : 761 [4] This page is based on a Wikipedia article written by contributors ( read / edit ). [wikiwand.com]
The treatment of the disease is usually difficult and often disappointing. Successful treatment with isotretinoin 1 mg/kg body mass could be achieved only after regular systematic administration in the course of 3–4 months. [scienceopen.com]
The treatment of the disease is usually difficult and often disappointing. Successful treatment with isotretinoin 1 mg/kg body mass could be achieved only after regular systematic administration in the course of 3-4 months. [doaj.org]
The treatment is usually difficult and often disappointing. In the case presented in the current work, the remission was achieved with nine-month isotretinoin treatment. [pubfacts.com]
What is the treatment for perifolliculitis capitis abscedens et suffodiens? Treatment of perifolliculitis capitis abscedens et suffodiens often requires a multi-pronged approach, especially initially and during acute flares. [dermnetnz.org]
Prognosis
In 2 patients, keratosis-ichthyosis-deafness (KID) syndrome has been reported to be associated with the follicular occlusion tetrad. [7, 8] Prognosis The prognosis for complete recovery from PCAS is poor. [thehealthscience.com]
The treatment measures may include the use of topical applications, oral medications, antibiotics, and cosmetic procedures, if necessary The prognosis of Dissecting Cellulitis of Scalp depends upon several factors including on the severity of the signs [dovemed.com]
The prognosis for complete recovery from PCAS is poor. [emedicine.medscape.com]
Etiology
Certain conditions have both an underlying etiology and multiple body system manifestations due to the underlying etiology. [icd10coded.com]
[…] with a combination therapy: Systemic antibiosis (Metronidazole Plus Clindamycin), dermatosurgical approach, and high-dose isotretinoin Abstract Read online Folliculitis et perifolliculitis capitis abscedens et suffodiens is a rare disease of unknown etiology [doaj.org]
Etiologic factors are unknown. Diagnosis is proven histologically. Management is very difficult and consists in systemic administration or intralesional injection of several drugs or in surgical manipulations. [ncbi.nlm.nih.gov]
(See Etiology and Pathophysiology, Treatment, and Medication.) [1, 2] PCAS is an uncommon disease. [thehealthscience.com]
The purpose of this paper is to report 6 cases observed by the authors at Letterman General Hospital and to add to the available information on the etiology, pathology, and treatment of this disease. [jamanetwork.com]
Epidemiology
From Etiology idiopathic Epidemiology occurs predominantly in black males in their second to fourth decade of life occurs less commonly in women & persons of different race Pathology dissecting cellulitis of the scalp Clinical-manifestations perifollicular [anvita.info]
A 17-year epidemiological study. ( 26774593 ) Lova-Navarro M....Crespo-Erchiga V. 2016 38 Tinea capitis outbreak among paediatric refugee population, an evolving healthcare challenge. ( 27061446 ) Mashiah J....Harel A. 2016 39 Factors in Etiology and [malacards.org]
You might also be interested in Dermatology Occurrence/Epidemiology This section has been translated automatically. Especially common among members of the black population/person of color. [altmeyers.org]
We discuss the diseases T related to the hair that may cause a red face and will present an update on their RI P epidemiology, clinics, pathogenesis, and therapy. [docksci.com]
Pathophysiology
Case Overview dissecting folliculitis Member Rated 0 Patient case no. 10926 Date added 02 February 2011 Patient details Age Adult Location Brazil Localisation Head / scalp Primary Lesions Cystic nodule Pathophysiology inflammatory skin appendage disorders [dermquest.com]
(See Etiology and Pathophysiology, Treatment, and Medication.) [1, 2] PCAS is an uncommon disease. [thehealthscience.com]
[…] improvement prior to starting isotretinoin.10 Combination oral rifampicin 300 mg and clindamycin 300 mg, both twice daily, increases overall efficacy in HS and reduces the risk of antibiotic resistance, and again while not studied in DCS the similar pathophysiology [jddonline.com]
Pathophysiology of these disorders is similar. Sebum secretion is increased within the sebaceous follicle by androgen stimulation. Keratin accumulates in the hair follicle as well as sebum. [accessemergencymedicine.mhmedical.com]
Indian Dermatol Online J 2014;5:491-3 Follicular occlusion tetrad is a complex consisting of four conditions having a similar pathophysiology. [idoj.in]
Prevention
Additionally, treatment involves preventing complications from occurring. One common form of treatment for dissecting cellulitis of the scalp is a course of antibiotics, which prevents further infections. [ecellulitis.com]
[…] of Perifolliculitis capitis abscedens Yes, it may be possible to prevent Perifolliculitis capitis abscedens. [tabletwise.net]
[…] minus' sign Virchow -triad Use Parentheses water AND (cup OR glass) Add an asterisk (*) at end of a word to include word stems Neuro* will search for Neurology, Neuroscientist, Neurological, and so on Use quotes to search for an exact phrase "primary prevention [readbyqxmd.com]
An understanding of response to damaging agents is central to the problems of preventing or forestalling the early effects of aging in skin (a goal that is responsible for the current expansion in dermatological research). [books.google.com]
[…] several factors including on the severity of the signs and symptoms Please find comprehensive information on Dissecting Cellulitis of Scalp regarding definition, distribution, risk factors, causes, signs & symptoms, diagnosis, complications, treatment, prevention [dovemed.com]