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Innovative Management of Recalcitrant Dissecting Cellulitis With Compression Therapy ONLINE FIRST

Eseosa Asemota, MD, MPH1; Yunyoung Claire Chang, MD1; Lynne J. Goldberg, MD1
[+] Author Affiliations
1Department of Dermatology, Boston University School of Medicine, Boston, Massachusetts
JAMA Dermatol. Published online August 10, 2016. doi:10.1001/jamadermatol.2016.2743
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This case report describes the use of an innovative technique to manage recalcitrant dissecting cellulitis.

Dissecting cellulitis of the scalp, also known as perifolliculitis capitis abscedens et suffodiens, is a chronic, relapsing, inflammatory disease that often results in scarring alopecia.1 Management of this condition includes medical and sometimes surgical treatments, but disease control can be challenging, and therapies are often ineffective or only temporarily effective.2 Medical therapies include oral isotretinoin, which many consider to be the treatment of choice1,3,4; antiseptics; topical, intralesional, and systemic steroids; topical and oral antibiotics; dapsone; colchicine; oral zinc sulfate; and tumor necrosis factor inhibitors.15 Surgical therapies, reserved for only severe, recalcitrant cases, include incision and drainage, local or complete excision with split-thickness skin grafting, laser hair removal, photodynamic therapy, and irradiation.4,5 We report use of an innovative technique in the management of this condition.

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Clinical Appearance of Dissecting Cellulitis Lesion Before and After Compression Therapy

A, A large, fluctuant lesion is present on the scalp before therapy. B, Complete resolution is present after 4 months of compression therapy.

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The American Medical Association is accredited by the Accreditation Council for Continuing Medical Education to provide continuing medical education for physicians. The AMA designates this journal-based CME activity for a maximum of 1 AMA PRA Category 1 CreditTM per course. Physicians should claim only the credit commensurate with the extent of their participation in the activity. Physicians who complete the CME course and score at least 80% correct on the quiz are eligible for AMA PRA Category 1 CreditTM.
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