Are dissecting cellulitis and hidradenitis suppurativa different diseases?

Area of Science:

• Dermatology
• Pathogenesis of skin conditions

Background:

• Dissecting cellulitis (DC) and hidradenitis suppurativa (HS) are distinct diagnoses with overlapping clinical, pathogenetic, and therapeutic features.
• Both conditions are associated with acne conglobata, forming the follicular occlusion triad or tetrad.
• DC involves perifolliculitis, abscesses, sinus tracts, and scarring alopecia on the scalp.
• HS is a chronic inflammatory disease of apocrine gland-rich areas, characterized by nodules, abscesses, sinus tracts, and scarring.

Purpose of the Study:

• To evaluate the overlapping features of dissecting cellulitis and hidradenitis suppurativa.
• To propose a unified classification for these related conditions.

Main Methods:

• Comparative analysis of clinical, dermatoscopic, pathogenetic, and histologic aspects of DC and HS.
• Review of existing literature on follicular occlusion disorders.

Main Results:

• Significant overlap exists between DC and HS in terms of clinical presentation, pathogenesis, and treatment modalities.
• The conditions share features such as perifolliculitis, abscess formation, sinus tracts, and scarring.
• Both are classified as neutrophilic, cicatricial alopecias or chronic inflammatory diseases.

Conclusions:

• DC and HS exhibit substantial similarities, supporting the hypothesis that they represent different localizations of a single disease process.
• Reclassifying DC and HS as variants of a follicular occlusion disease could improve diagnostic and therapeutic approaches.
• This unified perspective highlights the follicular occlusion disease occurring on the scalp (DC) and apocrine gland-rich areas (HS).