Demographic and Histopathological Evaluation in 71 Patients Diagnosed with Dissecting Cellulitis of the Scalp

Abstract

Background. Dissecting cellulitis of the scalp (DCS) is a recurrent condition in the hair follicle, resulting in permanent alopecia. Objective. We aimed to report the demographic and histopathologic characteristics in patients with dissecting cellulitis. Materials and Methods. We designed a cross-sectional study of patients with DCS who attended the Razi Dermatology Hospital from 2015 to 2019. Results. Seventy-one patients with a female to male ratio of 1 : 10 were recruited. The mean age of the patients was 21.6 years old (range: 13–69). Of them, 77.5% were younger than 32 years. The mean disease duration was 14 months (range: 3–84). Longer disease duration caused more severe disease ( $p$ value < 0.001). However, age and disease severity were not associated ( $p$ value > 0.05). Comorbidity with head and neck acne was found in 29 patients: the age of 28 patients was less than 32 years, which showed acne was associated with younger patients ( $p$ value < 0.001). Concerning the histopathological findings, the most frequent one was lymphoplasma cell infiltration in 90% of the specimens, followed by neutrophilic infiltration in 79%, irregular fibrosis in 66%, granulation tissue in 56%, folliculitis in 49%, deep dermal involvement in 49%, and granuloma in 38% of the cases. Conclusion. DCS was more frequent in men, and it was a disease of youth (second and third decades of life). Head and neck acne has concomitance with the disease, especially in young patients.