Korean J Dermatol.  2022 Mar;60(3):167-172.

Comparative Clinicopathological Analysis of Primary Neutrophilic Scarring Alopecia: Folliculitis Decalvans and Dissecting Cellulitis

Affiliations
  • 1Department of Dermatology, Hallym University Sacred Heart Hospital, Anyang, Korea

Abstract

Background
Folliculitis decalvans and dissecting cellulitis are types of primary neutrophilic cicatricial alopecia characterized by permanent hair loss. Clinicopathological differentiation is poorly described in literature.
Objective
This study aimed to determine the clinicopathological distinction between folliculitis decalvans and dissecting cellulitis.
Methods
A retrospective review was conducted in 45 patients diagnosed with dissecting cellulitis and folliculitis decalvans between 2011 and 2021. We reviewed the clinical features using electronic medical records, clinical photographs, and histopathologic features.
Results
Clinically, middle-aged men with folliculitis decalvans showed polytrichia (80%) and papulopustules (55%), while young men with dissecting cellulitis had deeply seated nodules (84%). Histopathologically, follicular plugging was more frequently observed in dissecting cellulitis (80%) than in folliculitis decalvans (50%). There was a difference in the depth of inflammation between the two types.
Conclusion
A difference in clinical manifestations was observed according to the depth of inflammation. These findings may contribute to the differential diagnosis of primary neutrophilic cicatricial alopecia.

Keyword

Alopecia; Alopecia cicatrisata; Dissecting cellulitis; Folliculitis decalvans; Pathology
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