Dissecting cellulitis is a scarring alopecia that more commonly affects men than women.
Authors from Brazil set out to assess the clinical features of women affected by DSC.
The study included a total of 17 females with a median age of 19 (range 13–68) years. Fitzpatrick skin types ranged from II to V. The most frequent patient characteristic was a normal body mass index (82.4%), non-smokers (82.3%), Fitzpatrick skin type II or III (70.6%), Caucasian hair (64.7%),
41 % of patients had hidradenitis suppurativa.
The most common affected area was the vertex scalp (70.6%), followed by the occipital area (58.8%). Pain, nodules, fistulas, and abscesses were the more common sings and symptoms. Painful nodules was present in 94 % of patients. Bacterial and fungal cultures were negative in 83.3 % of patients.
The most common treatments were isotretinoin and doxycycline were prescribed in 94.1% and 64.7% of the cases.
This is an interesting paper which highlights some key differences in women with DSC. DSC often affects males with Afro-textured hair. Here, women with DSC from this study in Brazil had mainly lighter skin types and caucasian hair. The incidence of hidradenitis was higher in this study than typically seen in male patients with DSC (41 % in this study vs 12 % in males).
This is a helpful reminder that the differential diagnosis of painful scalp nodules in women, especially those affecting the vertex and occipital scalp includes DSC.
Melo DF et al. Dissecting cellulitis in women: a retrospective multicenter study with 17 patients. Int J Dermatol. 2022 May 15. doi: 10.1111/ijd.16271. Online ahead of print.