Dissecting cellulitis of the scalp treated by tumour necrosis factor inhibitors: a case series

Eur J Dermatol. 2021 Feb 1;31(1):81-85. doi: 10.1684/ejd.2021.3969.

Abstract

Background: Dissecting cellulitis of the scalp (DCS), also known as Hoffmann disease or perifolliculitis capitis abscedens et suffodiens, is a rare disease characterized by chronic inflammation of the scalp. Treatment is difficult and often disappointing.

Objectives: To report our experience of TNF inhibitors in a series of patients with DCS.

Materials & methods: We conducted a monocentric retrospective study of nine patients with DCS treated with TNF blocker after failure of other conventional treatments.

Results: After a mean duration of treatment by TNF inhibitors of 17 ± 16 months, four patients (44% versus 0%) had a Physician's Global Assessment score of 0 or 1. We observed a 67% reduction in the number of inflammatory nodules, an 88% reduction in purulent drainage and a 45% improvement in Dermatology Life Quality Index. The mean treatment satisfaction index was 6.6 ± 1.6 out of 10.

Conclusion: Our study suggests that TNF inhibitors are effective against disease activity and may improve quality of life in the management of DCS refractory to conventional treatments.

Keywords: adalimumab; infliximab; issecting cellulitis of the scalp.

MeSH terms

  • Adult
  • Cellulitis / drug therapy*
  • Female
  • Humans
  • Male
  • Middle Aged
  • Retrospective Studies
  • Scalp Dermatoses / drug therapy*
  • Skin Diseases, Genetic / drug therapy*
  • Tumor Necrosis Factor Inhibitors / therapeutic use*
  • Young Adult

Substances

  • Tumor Necrosis Factor Inhibitors

Supplementary concepts

  • Perifolliculitis Capitis Abscedens Et Suffodiens, Familial