Author: Dr Ian Coulson, Consultant Dermatologist and Editor-in-Chief, 2022.
Edited by the DermNet content department
This 23-year-old man has a 3-year history of lesions on his scalp. These lesions can be painful and fluctuant swellings often discharge.
This is dissecting cellulitis of the scalp, also known as perifolliculitis capitis abscedens et suffodiens and Hoffman disease. It produces nodules, cysts, and discharging scalp lesions with eventual patchy scarring hair loss (alopecia).
It may be associated with severe acne (including acne conglobata) and hidradenitis suppurativa, collectively called the follicular occlusion triad. More recently, pilonidal sinus disease has been added to this list (follicular occlusion tetrad).
Therapy is difficult. It involves considering the following:
