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Dissecting Cellulitis Presenting After Hair Restoration Surgery
Guillermo A Guerrero-González1, Gerardo González-Martínez2, Jair A Valdez-Zertuche2
1Dermatologic Surgery, Pango Dermatología, Monterrey, MEX.
Cureus
|December 24, 2024
Summary
Dissecting cellulitis (DC) of the scalp, a rare condition, can occur after follicular unit extraction (FUE). Early diagnosis and treatment with isotretinoin and dutasteride are key to preventing permanent hair loss.
Area of Science:
- Dermatology
- Trichology
Background:
- Dissecting cellulitis (DC) is a chronic scalp inflammation causing scarring alopecia, often linked to staphylococcal antigens.
- It is frequently associated with other follicular occlusion disorders.
Observation:
- A case report details a 34-year-old male with scarring acne who developed DC post-follicular unit extraction (FUE).
- Trichoscopy revealed characteristic findings: brown pigmented dots, erythema, and melicerous crusts.
- Bacterial cultures from abscess drainage were negative.
Findings:
- The patient received a diagnosis of DC and was treated with isotretinoin, dutasteride, intralesional steroids, and a salicylic acid shampoo.
- Significant improvement was observed after four months, with trichoscopy showing hair regrowth and no further hair loss.
- This marks the first reported instance of DC following FUE.
Implications:
- Dissecting cellulitis is a potential complication of follicular unit extraction, particularly in patients with acne.
- Trichoscopy is vital for diagnosing and monitoring DC.
- Personalized treatment strategies, including isotretinoin and potentially dutasteride, are effective in managing DC and preventing scarring alopecia.
