What are the other Names for this Condition? (Also known as/Synonyms)

• DCS (Dissecting Cellulitis of Scalp)
• Dissecting Scalp Cellulitis
• Perifolliculitis Capitis Abscedens Et Suffodiens (PCAS)

What is Dissecting Cellulitis of Scalp? (Definition/Background Information)

• Dissecting Cellulitis of Scalp (DCS) is an uncommon condition that causes inflammation of the hair follicles on the scalp. The condition is mostly observed in dark-skinned adult men
• The cause of Dissecting Cellulitis of Scalp is generally unknown, but it is known to be associated with spinal arthritis and can occur as a part of follicular occlusion syndrome
• Dissecting Cellulitis of Scalp is characterized by the appearance of boils on the scalp. Over time, the boils can rupture, bleed, and ooze pus. The skin lesions can lead to scarring and hair loss
• The condition is typically difficult to treat. 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 and symptoms

Who gets Dissecting Cellulitis of Scalp? (Age and Sex Distribution)

• Dissecting Cellulitis of Scalp is a rare condition that is usually seen in adult men (20-40 years). It is not frequently found in children and women
• Both males and females may be affected, although a higher number of cases are reported among males
• Individuals of all racial and ethnic background may be affected. But, dark-skinned individuals are affected much more than fair-skinned individuals (such as Caucasians)

What are the Risk Factors for Dissecting Cellulitis of Scalp? (Predisposing Factors)

• The risk factor for Dissecting Cellulitis of Scalp is generally unknown, but the condition is known to be associated with spondyloarthropathy or spinal arthritis
• It can form a part of follicular occlusion syndrome along-with other skin conditions that include hidradenitis suppurativa, acne conglobate, a serious scarring form of acne,, and pilonidal sinus

It is important to note that having a risk factor does not mean that one will get the condition. A risk factor increases ones chances of getting a condition compared to an individual without the risk factors. Some risk factors are more important than others.

Also, not having a risk factor does not mean that an individual will not get the condition. It is always important to discuss the effect of risk factors with your healthcare provider.

What are the Causes of Dissecting Cellulitis of Scalp? (Etiology)

The cause of development of Dissecting Cellulitis of Scalp is unknown.

• This disorder develops when the hair follicle of the scalp gets inflamed (cellulitis or inflammation of the soft tissues), which results in the formation of nodules
• Research is currently being undertaken to identify the relevant causal factors

What are the Signs and Symptoms of Dissecting Cellulitis of Scalp?

The signs and symptoms of Dissecting Cellulitis of Scalp may include:

• Formation of small-sized or large-sized nodules or pustules on the scalp, due to inflammation of the hair-follicles
• The nodules may be painful and can rupture to discharge pus; the hair around the lesion may clump together due to the destruction of follicle associated structures
• Some lesions may be longstanding, while fresh lesions may appear constantly
• There may be hair loss around the affected area, which may be temporary

Some cases are mild, while others are severe. Severe conditions are difficult to treat.

How is Dissecting Cellulitis of Scalp Diagnosed?

A diagnosis of Dissecting Cellulitis of Scalp may involve the following:

• A thorough medical history and physical examination
• Blood tests, as needed
• Dermoscopy: It is a diagnostic tool where a dermatologist examines the skin using a special magnified lens
• Wood’s lamp examination: In this procedure, the healthcare provider examines the skin using ultraviolet light. It is performed to examine the change in skin pigmentation
• Analysis of pus, culture of the draining fluid 
• Skin biopsy: A skin biopsy is performed and sent to a laboratory for a pathological examination. The pathologist examines the biopsy under a microscope. After putting together clinical findings, special studies on tissues (if needed) and with microscope findings, the pathologist arrives at a definitive diagnosis

Many clinical conditions may have similar signs and symptoms. Your healthcare provider may perform additional tests to rule out other clinical conditions to arrive at a definitive diagnosis.

What are the possible Complications of Dissecting Cellulitis of Scalp?

Dissecting Cellulitis of Scalp is an uncommon condition affecting the hair follicles. It may result in the following complications:

• Emotional and psychological stress
• Secondary bacterial and fungal skin infections, which may result in fever and other associated signs and symptoms
• Scarring of the affected scalp region leading to cosmetic issues
• Permanent loss of hair (alopecia), with exposure of the scars
• The condition is generally difficult to treat

How is Dissecting Cellulitis of Scalp Treated?

The treatment of Dissecting Cellulitis of Scalp is typically challenging. It may involve the following:

• Use of self-care measures, such as washing with mild soap (antibacterial) and applying warm compress
• Oral isotretinoin, oral dapsone therapy
• Administration of systemic steroids
• Medications, such as antibiotics, may be used for bacterial infection, or even in the absence of documented pathogens
• Under local anesthesia, a cosmetic procedure called dermabrasion is performed. In this procedure, the raised lumpy scars and skin dark spots are abraded (rubbed-off)
• Laser epilation therapy (for hair follicles) - this therapy has yielded some promising results
• In case it is associated with follicle occlusion syndrome, then treatment of the underlying condition is necessary

How can Dissecting Cellulitis of Scalp be Prevented?

Currently, there are no known methods to prevent Dissecting Cellulitis of Scalp occurrence.

What is the Prognosis of Dissecting Cellulitis of Scalp? (Outcomes/Resolutions)

• Dissecting Cellulitis of Scalp is a spontaneously developing, longstanding condition that is difficult to treat and manage
• The prognosis of the condition generally depends upon the severity of the signs and symptoms and its response to treatment
• With suitable treatment, the hair can grow back on the affected scalp area

Additional and Relevant Useful Information for Dissecting Cellulitis of Scalp:

• There is no evidence to prove that oily foods and chocolate-based products have an influence on Dissecting Cellulitis of Scalp formation
• Cleaning the skin too hard with strong chemicals or soaps may aggravate the skin condition. Care must be taken avoid strong soaps and chemicals that could potentially worsen the condition
• The presence of dirt on the body is not a causative factor for the condition. However, it helps to be clean and hygienic, which may help the condition from getting worse