Nódulos alopécicos y asépticos de la piel cabelluda en un varón, manifestación atípica de una celulitis disecante.

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Bibliographic Details
Title:	Nódulos alopécicos y asépticos de la piel cabelluda en un varón, manifestación atípica de una celulitis disecante.
Alternate Title:	Alopecic and aseptic nodules on the scalp in a male, an atypical presentation of dissecting cellulitis.
Authors:	Conquett Huertas, Johan¹ conquett15@gmail.com, González Saldarriaga, Isabella¹, Candelo Viáfara, Paula²
Source:	Dermatología Revista Mexicana. sep/oct2025, Vol. 69 Issue 5, p696-699. 4p.
Subjects:	CELLULITIS, BALDNESS, HISTOPATHOLOGY, CUTANEOUS manifestations of general diseases, ALOPECIA areata
Abstract (English):	BACKGROUND: Dissecting cellulitis, or Hoffman's disease, is a rare type of primary neutrophilic cicatricial alopecia with unclear etiology, which may be associated with other follicular occlusion disorders, forming part of the so-called follicular tetrad. It clinically manifests as suppurative nodules that can form sinus tracts, primarily affecting the vertex and posterior scalp. Generally, the exudate is sterile, but secondary infection by S. aureus, P. aeruginosa, and anaerobic bacteria may occur. Patients may also complain of itching and pain depending on the degree of inflammation. CLINICAL CASE: A 45-year-old male patient, Fitzpatrick skin type II, with discrete aseptic nodules, focal areas of cicatricial alopecia on the scalp, nonspecific trichoscopic signs, and conclusive histopathological findings of neutrophilic alopecia. CONCLUSIONS: Dissecting cellulitis is a rare dermatological condition that can lead to cicatricial alopecia. This illness remains a diagnostic challenge due to the different clinical spectra it may present, and awareness of its atypical or infrequent manifestations is useful when evaluating patients with alopecia. This knowledge can facilitate timely management to prevent disease progression. [ABSTRACT FROM AUTHOR]
Abstract (Spanish):	ANTECEDENTES: La celulitis disecante, o enfermedad de Hoffman, es un tipo raro de alopecia cicatricial neutrofílica primaria, de causa poco clara, que puede asociarse con otros trastornos de oclusión folicular, formando parte de la denominada tétrada folicular. Se manifiesta como nódulos supurativos que pueden formar trayectos y que afectan, principalmente, el vértice y la zona posterior de la piel cabelluda. Por lo general, el exudado es estéril, pero puede haber infección agregada por S. aureus, P. aeruginosa y bacterias anaerobias. Los pacientes refieren prurito y dolor según el grado de inflamación. CASO CLÍNICO: Paciente masculino de 45 años, fototipo II, con nódulos asépticos discretos, áreas focales de alopecia cicatricial en la piel cabelluda, signos tricoscópicos inespecíficos y hallazgos histopatológicos concluyentes de alopecia neutrofílica. Se trató con doxiciclina 100 mg/día, infiltraciones intralesionales con triamcinolona 10 mg/mL, lavado con jabón de clorhexidina tres veces por semana. Un mes después de iniciado el tratamiento el paciente mostró alivio de las lesiones. CONCLUSIONES: La celulitis disecante es una enfermedad dermatológica rara que puede conducir a alopecia cicatricial. Es un reto diagnóstico debido a los diferentes espectros clínicos que puede tener y conocer sus manifestaciones atípicas o infrecuentes será de utilidad al momento de evaluar a los pacientes con alopecia y así poder indicar un tratamiento oportuno que evite la evolución de la enfermedad. [ABSTRACT FROM AUTHOR]
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Database:	MedicLatina

Description
Abstract:	BACKGROUND: Dissecting cellulitis, or Hoffman's disease, is a rare type of primary neutrophilic cicatricial alopecia with unclear etiology, which may be associated with other follicular occlusion disorders, forming part of the so-called follicular tetrad. It clinically manifests as suppurative nodules that can form sinus tracts, primarily affecting the vertex and posterior scalp. Generally, the exudate is sterile, but secondary infection by S. aureus, P. aeruginosa, and anaerobic bacteria may occur. Patients may also complain of itching and pain depending on the degree of inflammation. CLINICAL CASE: A 45-year-old male patient, Fitzpatrick skin type II, with discrete aseptic nodules, focal areas of cicatricial alopecia on the scalp, nonspecific trichoscopic signs, and conclusive histopathological findings of neutrophilic alopecia. CONCLUSIONS: Dissecting cellulitis is a rare dermatological condition that can lead to cicatricial alopecia. This illness remains a diagnostic challenge due to the different clinical spectra it may present, and awareness of its atypical or infrequent manifestations is useful when evaluating patients with alopecia. This knowledge can facilitate timely management to prevent disease progression. [ABSTRACT FROM AUTHOR]
ISSN:	01854038
DOI:	10.24245/dermatolrevmex.v69i5.10743