Edit concept Question Editor Create issue ticket

Perifolliculitis Capitis Abscedens

Follic Abscedens Et Suffodiens


Presentation

  • 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]
  • The case of a 26-year-old male patient with perifolliculitis capitis abscedens et suffodiens (PCAS) who later developed hidradenitis suppurativa (HS) and exacerbation of acne is presented.[ncbi.nlm.nih.gov]
  • An 18 year-old white patient with cystic infiltrations, alopecia plaques, pustules and other inflammatory elements (clinicohistological features consistent with dissecting folliculitis of the scalp), is presented.[ncbi.nlm.nih.gov]
  • A 19-year-old man presented with PCAS for 2 years; multiple systemic antibiotic therapies and surgical approaches had shown no effect. Monotherapy with isotretinoin 80 mg daily for 4 weeks had not been successful.[ncbi.nlm.nih.gov]
  • In the case presented in the current work, the remission was achieved with nine-month isotretinoin treatment.[ncbi.nlm.nih.gov]
Fever
  • 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]
  • In September 2008, the condition worsened with the increase of the number of lesions and constitutional compromise with fever and arthralgia, initially managed at a periphery hospital center with clindamycin and intravenous oxacillin without improvement[colombiamedica.univalle.edu.co]
  • 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]
  • 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]
  • There was no history of recurrent fever or weight loss. There was no history of abnormal bowel movements or any other systemic complaints. There was no family history of similar complaints, though his father suffered from psoriasis.[idoj.in]
Malaise
  • Regional lymphadenopathy, fever and malaise may be associated features.[docksci.com]
Alopecia
  • Isotretinoin topical application assured successful control of the disease and averted the evolution of the clinical aspect to scarring alopecia and nodule formation.[ncbi.nlm.nih.gov]
  • Perifolliculitis capitis abscedens et suffodiens (PCAS) is a suppurative process that involves the scalp, eventually resulting in extensive scarring and irreversible alopecia. This condition often presents in males of African American origin.[ncbi.nlm.nih.gov]
  • 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]
  • It is often accompanied by scarring alopecia, acne conglobata, and recurrent fluctuant abscesses. PCAS belongs to the family of acne inversa (hidradenitis suppurativa).[ncbi.nlm.nih.gov]
Hyperhidrosis
  • Yamauchi has also spoken on other dermatologic conditions at national and local meetings and has published many peer-reviewed articles including acne, eczema, skin manifestations associated with rheumotologic conditions, and hyperhidrosis.[books.google.it]
Pruritus Vulvae
  • vulvae 631 201 Pseudofolliculitis barbae 634 202 Pseudoxanthoma elasticum 638 203 Psoriasis 640 204 Psychogenic excoriation 651 205 Pyoderma gangrenosum 654 206 Pyogenic granuloma 659 207 Radiation dermatitis 662 208 Raynaud disease and phenomenon 665[books.google.com]

Workup

Treponema Pallidum
  • PCR failed to detect Treponema pallidum , Bartonella , Mycoplasma and Mycobacteria . A skin biopsy of the occipital region showed dissecting dermatitis with abscess formation (Fig. 2).[medicaljournals.se]
HLA-B27
  • Coexistence with acne conglobata or hidradenitis suppurativa is present in 1/3 of the cases, which implies a risk for developing seronegative spondyloarthropathies HLA-B27, with compromise of axial joints or asymmetric peripheral arthritis.[colombiamedica.univalle.edu.co]
  • Systemic Implications and Complications HLA B27-negative erosive and proliferative peripheral as well as axial arthropathy can be seen on radiologic examination of symptomatic patients. polyarthralgia may precede or follow the scalp disease.[dermatologyadvisor.com]

Treatment

  • The treatment has been well tolerated by the patient for 15 months at time of writing this report.[ncbi.nlm.nih.gov]
  • The clinician dealing with patients suffering from PCAS has several treatment options available to help successfully manage patients with straightforward or recalcitrant disease.[ncbi.nlm.nih.gov]
  • 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.[ncbi.nlm.nih.gov]
  • This, to our knowledge, is the first report documenting effective treatment of this condition, whose nosologic position with respect to other spondyloarthropathies associated with cutaneous disease is considered.[ncbi.nlm.nih.gov]
  • A response to treatment was excellent and rapid. The treatment of PCAS represents usually difficulties and frustration for both the patient and the physician.[ncbi.nlm.nih.gov]

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]
  • Acute diffuse and total alopecia: A new subtype of alopecia areata with a favorable prognosis. J Am Acad Dermatol. 2009;60:85-93. 10. Strober B, Menon K, McMichael A, Hordinsky M, et al. Alefacept for severe alopecia mareata.[revistasocolderma.org]

Etiology

  • Certain conditions have both an underlying etiology and multiple body system manifestations due to the underlying etiology.[icd10coded.com]
  • A literature review on the etiology, pathology, differential diagnosis, and management is also discussed. Careful analysis of the pathology and clinical presentation can aid in the timely diagnosis and management of this challenging condition.[ncbi.nlm.nih.gov]
  • 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]
  • Perifolliculitis capitis abscedens et suffodiens (PCAS) is a rare scalp disease of unknown etiology which is hard to treat. It is often accompanied by scarring alopecia, acne conglobata, and recurrent fluctuant abscesses.[ncbi.nlm.nih.gov]
  • (See Etiology and Pathophysiology, Treatment, and Medication.) [1, 2] PCAS is an uncommon disease.[thehealthscience.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]
  • AE...Micali G 2017 12 Epidemiology, clinical presentation and therapeutic approach in a multicentre series of dissecting cellulitis of the scalp. ( 27558283 ) Segurado-Miravalles G....VaA A -GalvA![malacards.org]
  • 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]
  • There appears to be an association with acne conglobata and hidradenitis suppurativa, collectively known as the follicular occlusion triad, [115] or tetrad when also associated with pilonidal cysts. [20] Epidemiology Dissecting cellulitis of the scalp[medscape.com]
  • 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]
Sex distribution
Age distribution

Pathophysiology

  • (See Etiology and Pathophysiology, Treatment, and Medication.) [1, 2] PCAS is an uncommon disease.[thehealthscience.com]
  • 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]
  • Indian Dermatol Online J 2014;5:491-3 Follicular occlusion tetrad is a complex consisting of four conditions having a similar pathophysiology.[idoj.in]
  • In the light of the advance in clinical, histopathological and pathophysiological findings, we propose the term "dissecting terminal hair folliculitis" (DTHF) to characterize its disease nature as folliculitis instead of acneiform disease or apocrine[pubfacts.com]

Prevention

  • […] 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]
  • However, the lack of clinical studies regarding DC prevents full understanding of the disease and limits the ability to define a consensus treatment algorithm.[ncbi.nlm.nih.gov]
  • What they found adds to... [ Read Full Story ] May 10, 2019 If your provider is ordering nebulizers and the drugs used in them for their patients here are things in the documentation that will help prevent a resubmission to Medicare and ease medical coding[coder.aapc.com]

Ask Question

5000 Characters left Format the text using: # Heading, **bold**, _italic_. HTML code is not allowed.
By publishing this question you agree to the TOS and Privacy policy.
• Use a precise title for your question.
• Ask a specific question and provide age, sex, symptoms, type and duration of treatment.
• Respect your own and other people's privacy, never post full names or contact information.
• Inappropriate questions will be deleted.
• In urgent cases contact a physician, visit a hospital or call an emergency service!