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What Is The Cause And Treatment For Dissecting Cellulitis Of The Scalp?
Question: My son began to notice bumps on his scalp approximately 20 years of age. Before then he had a full head of beautiful hair. We went to see his doctor and they never diagnosed him or took a biopsy of his scalp. We have gone to the doctor's office many times, unfortunately he was continuously given benzoyl peroxide creams, and told he just has a build up of hair follicles. It was very difficult to even get his primary care doctor to give him a dermatology consult. We have been dealing with this issue for several years, he is 23 now. I was so frustrated to the point where I actually researched his symptoms online and diagnosed him myself. After finding out what I was sure I thought he had, I paid out of pocket for him to be seen by a dermatologist. I just wish I had done this sooner. I feel horrible as his mom, and feel as if I let him down. Unfortunately, my diagnosis was correct and he does have dissecting cellulitis. Luckily, he tries to maintain good spirits, but he experiences a lot of discomfort. I don't know what to do to help him! The dermatologist does not specialize in this and immediately just wants to start him on accurate. My question is I've heard horrible things about the side affects of this medication, how dangerous is it and does it really help? How do you treat this disease? Does accurate work? Why can't I find any doctor's who specialize in this disease? Please help! Signed concerned mom, XXXXXXX
Brief Answer:
Dissecting cellulitis and its management
Detailed Answer:
Hello,
Welcome to healthcare magic.
I understand from your query that your son is probably suffering from Dissecting cellulitis of the scalp from the past 3 years.
Dissecting cellulitis is a chronic disease which could cause significant distress, both physically and emotionally and I understand your concern about its course and treatment.
Among the various options available for its management, oral antibiotics and Isotretinoin have shown to give good results. Antiiotics also play a minimal role only to treat the secondary infection and not the primary disease per se.
Isotretinoin ( Accutane ), so far has been shown to give the best results.
You do not have to worry about the side effects of the drug. It is a very useful drug if given under supervision and monitoring. We give it routinely for patients with severe acne ( most common indication). Liver function test and lipid profile have to be monitored monthly while on this drug.
The most common side effects seen are dryness of the skin and lips, which can be easily managed with topical emollients like petroleum jelly. It could cause transient rise in the liver enzymes, which is not very common and is reversible on stopping the drug. Other side effects mentioned are not routinely seen in practice.
Considering the obvious distress that your son is going through, it would definitely be worth giving this a try.
Hope this helps you.
If you have any more queries, I would be glad to assist.
Wishing you and your son good health,
Dr. Johny Chacko
Dissecting cellulitis and its management
Detailed Answer:
Hello,
Welcome to healthcare magic.
I understand from your query that your son is probably suffering from Dissecting cellulitis of the scalp from the past 3 years.
Dissecting cellulitis is a chronic disease which could cause significant distress, both physically and emotionally and I understand your concern about its course and treatment.
Among the various options available for its management, oral antibiotics and Isotretinoin have shown to give good results. Antiiotics also play a minimal role only to treat the secondary infection and not the primary disease per se.
Isotretinoin ( Accutane ), so far has been shown to give the best results.
You do not have to worry about the side effects of the drug. It is a very useful drug if given under supervision and monitoring. We give it routinely for patients with severe acne ( most common indication). Liver function test and lipid profile have to be monitored monthly while on this drug.
The most common side effects seen are dryness of the skin and lips, which can be easily managed with topical emollients like petroleum jelly. It could cause transient rise in the liver enzymes, which is not very common and is reversible on stopping the drug. Other side effects mentioned are not routinely seen in practice.
Considering the obvious distress that your son is going through, it would definitely be worth giving this a try.
Hope this helps you.
If you have any more queries, I would be glad to assist.
Wishing you and your son good health,
Dr. Johny Chacko
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
Thank you so much for your reply. My son has an appointment with a dermatologist in about two weeks, during the consult they did talk about starting him on accutane...I was a little concerned, but you have provided some comfort. I have also read about topical steroid treatments or injections, has this been helpful for patients. Thank you!!
Brief Answer:
Dissecting cellulitis and its management
Detailed Answer:
Hello,
Topical steroids are not of much use as they cannot be used for prolonged periods.
Intralesional steroids are useful if there are a limited number of lesions and the disease is not very active. They are also associated with side effects and cannot be given too many times. It is sometimes reserved for treating those nodules which crop up once the disease has come into control with drugs like Isotretinoin.
Hope this answers your query.
Regards,
Dr. Johny Chacko
Dissecting cellulitis and its management
Detailed Answer:
Hello,
Topical steroids are not of much use as they cannot be used for prolonged periods.
Intralesional steroids are useful if there are a limited number of lesions and the disease is not very active. They are also associated with side effects and cannot be given too many times. It is sometimes reserved for treating those nodules which crop up once the disease has come into control with drugs like Isotretinoin.
Hope this answers your query.
Regards,
Dr. Johny Chacko
Note: Hope the answers resolves your concerns, however for further guidance of skin related queries consult our Dermatologist.Click here to book a consultation
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
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