isotretinoin and Scalp-Dermatoses

Perifolliculitis capitis abscedens et suffodiens (PCAS) is a rare, suppurative dermatosis of the scalp, the etiology of which remains unknown. It is characterized by the development of comedones, perifollicular pustules, firm or fluctuant and itchy or painful nodules and abscesses of the scalp, connected by communicating sinuses that may lead to the formation of scarring and irreversible alopecia. Treatment of PCAS is challenging, often leading to unsatisfactory results. We present a case of a 23-year-old Caucasian man with PCAS who was treated successfully with systemic isotretinoin monotherapy and we review the current therapeutic options.

Topics: Adult; Cellulitis; Dermatologic Agents; Humans; Isotretinoin; Male; Scalp Dermatoses; Young Adult

Erosive pustular dermatosis of the scalp is a rare condition which primarily affects older women after local trauma and has historically been treated with topical steroids. As it is a rare entity and resembles other dermatologic conditions, it may easily be misdiagnosed. Identifying the causes and evaluating the efficacy of treatments of erosive pustular dermatosis of the scalp (EPDS) is of great importance to both avoid misdiagnosis and ensure optimal treatment of this rare condition. There are numerous causes. In addition to surgeries and physical injuries, topical and procedural treatments for actinic keratoses and androgenetic alopecia can trigger the development of lesions. There are also documented associations with several autoimmune and systemic conditions. Besides corticosteroids, topical tacrolimus and photodynamic therapy were the most commonly used treatments for EPDS. They were effective with few recurrences and adverse effects. Other successful treatment options were topical dapsone, silicone gels, calcipotriol, acitretin, and isotretinoin. Oral dapsone can be used in cases of disseminated disease. Zinc sulfate should be considered with low-serum zinc levels. While cyclosporine was effective, there were adverse effects that may limit its use. It is important for dermatologists to be aware of the wide array of potential causes of erosive pustular dermatosis and include it on their differential. Additionally, although high-potency topical steroids have been historically used as the first-line treatment, there are many other effective treatments that may avoid recurrence and skin atrophy, particularly in the elderly population.

Topics: Acitretin; Adrenal Cortex Hormones; Aminolevulinic Acid; Anti-Infective Agents; Calcitriol; Dapsone; Dermatologic Agents; Humans; Immunosuppressive Agents; Isotretinoin; Keratolytic Agents; Photochemotherapy; Scalp Dermatoses; Tacrolimus

Dissecting cellulitis of the scalp is a primary scarring alopecia. Isotretinoin is commonly referenced in the literature as a treatment for dissecting cellulitis. The objective of this article was to conduct a review and meta-analysis to assess the efficacy of isotretinoin for treating dissecting cellulitis of the scalp.. The following databases were searched for articles prior to 23 June, 2019: PubMed, Embase, Cochrane Central, CINAHL, and Web of Science. Multi-patient studies (more than three) that reported on the administration of isotretinoin for dissecting cellulitis were included. A pooled meta-analysis for improvement of disease burden after isotretinoin administration in patients with dissecting cellulitis of the scalp was performed. A fixed-effects model was used.. Five articles were ultimately used for the quantitative meta-analysis. The overall efficacy rate of isotretinoin in treating dissecting cellulitis of the scalp was estimated to be 0.9 with a 95% confidence interval (0.81-0.97). The sensitivity analysis suggested that the overall efficacy is still very high, with a range of 0.83-0.94. Recurrence was seen in 24% (6/25) of patients. Common associated diseases amongst patients with dissecting cellulitis of the scalp were acne conglobata 20% (30/151) and hidradenitis suppurativa 19% (11/72).. Isotretinoin is an effective treatment for improving symptoms of dissecting cellulitis of the scalp. Disease recurrence is a common finding for those who undergo successful treatment.

Topics: Adolescent; Adult; Alopecia; Cellulitis; Child; Dermatologic Agents; Female; Humans; Isotretinoin; Male; Middle Aged; Recurrence; Retrospective Studies; Scalp Dermatoses; Treatment Outcome; Young Adult

Dissecting cellulitis is a chronic inflammatory dermatosis that results in disfiguring and painful, purulent lesions. Treatment of patients with disease resistant to standard therapies, including intralesional or topical steroids or antibiotics, can be a dilemma for clinicians.. We performed a systematic review of the literature in November 2018 to find articles which presented treatment options and outcomes of patients who failed prior treatment with standard therapies.. We identified 57 articles of interest, with 53 being case studies or series. Isotretinoin was the most often reported, but the response was limited. Biologics and laser therapy were used less often but demonstrated a better chance of remission. X-ray epilation and surgical excision demonstrated the best remission rates but can be complicated by serious morbidity.. We propose a regimen for the treatment of recalcitrant cases of dissecting cellulitis. In the future, more robust studies including randomized control trials are needed to identify the preferred treatment options for refractory dissecting cellulitis.

Topics: Adalimumab; Anti-Bacterial Agents; Cellulitis; Humans; Isotretinoin; Lasers, Gas; Lasers, Solid-State; Photochemotherapy; Scalp Dermatoses; Skin Diseases, Genetic; Steroids

Topics: Adolescent; Adult; Age of Onset; Cellulitis; Dermatologic Agents; Disease Progression; Female; Humans; Isotretinoin; Male; Middle Aged; Retrospective Studies; Scalp Dermatoses; Skin Diseases, Genetic; Young Adult

Erosive pustular dermatosis of the scalp (EPDS) is a rare entity characterized by pustular, erosive and crusted lesions of the scalp with progressive scarring alopecia. The aetiology is unknown, but predisposing factors have been reported such as trauma, skin grafting, prolonged exposure to UV light of a bald scalp as well as co-existence of auto-immune diseases. Laboratory data, bacteriological and mycological investigations and histopathology are generally not diagnostic. A 45-year-old Caucasian man with 1-year-old pustular, erosive and crusted lesions on his bald scalp was seen. Laboratory data, including auto-immunity, bacteriological and mycological investigations were negative. Histopathology was not diagnostic showing a diffuse polymorphous infiltrate involving the dermis. A diagnosis of EPDS was made. The patient was treated with topical and systemic antibiotics and steroids as well as oral nimesulide with no or partial response. Consequently, isotretinoin (0.75 mg/kg/day) was started obtaining complete resolution in few months. No relapse after 1 year of follow-up was seen. EPDS represents a distinct disease with a history of relapsing and unsatisfactory response to common treatments. Systemic retinoids may be considered as a potentially resolutive choice.

Topics: Administration, Topical; Anti-Bacterial Agents; Dermatologic Agents; Humans; Isotretinoin; Male; Middle Aged; Scalp Dermatoses; Skin Care; Skin Diseases, Vesiculobullous; Treatment Outcome

Dissecting cellulitis is an uncommon, chronic, progressive suppurative disease of unknown etiology. It is characterized by painful papules and nodules, interconnecting sinus tracts, purulent drainage, and scarring alopecia. This disease predominately affects young black men, but is rarely reported in white males. The refractory nature of this process makes treatment difficult. We report a case of dissecting cellulitis in a white male, which responded to oral isotretinoin.

Topics: Administration, Oral; Adult; Cellulitis; Humans; Isotretinoin; Male; Scalp Dermatoses

Three patients developed erosive pustular dermatosis of the scalp (EPDS). Two of them, both males, had previously undergone surgical excision for squamous cell carcinoma and basal cell carcinoma, and a female experienced avulsive trauma of the scalp. The erosive lesions and crusts were located at the site of a skin graft; microbiological cultures were negative for bacterial and fungal growth. Histological examination ruled out pustular bullous disorders. Topical therapy with corticosteroids and antibiotics resulted in clinical remission in only 2 cases. The third case showed a tendency to recur despite numerous therapeutic attempts with oral dapsone and isotretinoin. We conclude that surgical trauma is a possible cause of EPDS. Our patients seem to be the first reported cases of EPDS in skin grafts following plastic surgical procedures.

Topics: Administration, Cutaneous; Administration, Oral; Aged; Anti-Bacterial Agents; Anti-Infective Agents; Anti-Inflammatory Agents; Bacteria; Betamethasone; Carcinoma, Basal Cell; Carcinoma, Squamous Cell; Dapsone; Female; Fungi; Gentamicins; Humans; Isotretinoin; Keratolytic Agents; Male; Middle Aged; Recurrence; Remission Induction; Scalp; Scalp Dermatoses; Skin Diseases, Vesiculobullous; Skin Neoplasms; Skin Transplantation

Topics: Adrenal Cortex Hormones; Adult; Anti-Infective Agents, Local; Cerebellar Neoplasms; Female; Hemangiosarcoma; Humans; Isotretinoin; Scalp Dermatoses; Skin Diseases, Vesiculobullous

The efficacy of low-dose oral isotretinoin in the treatment of seborrhea and seborrheic dermatitis has been poorly investigated in randomized studies.. This study was designed to determine the efficacy and safety of low-dose oral isotretinoin in the treatment of moderate to severe seborrhea and seborrheic dermatitis on the scalp and/or face.. A randomized, comparative clinical trial, using two groups, was conducted over 6 months. Patients in Group ISO were treated with isotretinoin 10 mg every other day. In Group X, patients received antiseborrheic topical treatment. Patient opinion, investigator assessment, scalp pruritus, sebum production, and quality of life (QoL) comprised the efficacy outcomes.. The intention-to-treat population comprised a total of 45 patients with mean ± standard deviation ages of 28.7 ± 5.8 years in Group ISO and 29.8 ± 6.5 years in Group X. The rate of sebum production significantly decreased in Group ISO. Patient opinion, investigator, and QoL assessments improved in both groups.. Low-dose oral isotretinoin can be a therapeutic modality for moderate to severe seborrhea and seborrheic dermatitis.

Topics: Administration, Ophthalmic; Adult; Dermatitis, Seborrheic; Dermatologic Agents; Facial Dermatoses; Female; Humans; Isotretinoin; Male; Patient Satisfaction; Pruritus; Quality of Life; Scalp Dermatoses; Sebum; Severity of Illness Index; Young Adult

Retinoids have been shown to improve the manifestations of skin photodamage, including actinic keratoses.. The efficacy and tolerability of isotretinoin 0.1% cream in the treatment of actinic keratoses were evaluated in a randomized, double-blind, placebo-controlled, parallel-group study.. One hundred patients were randomly assigned to treatment with 0.1% cream or vehicle twice daily for 24 weeks to the face, the scalp, and the upper extremities. Patients were assessed every 4 weeks by the investigators, who counted and recorded the number of lesions in each treatment area. The 93 patients who had at least one postbaseline assessment were included for efficacy analysis. Local tolerability was evaluated at each study visit.. On the face, the reduction in number of actinic keratoses (mean +/- SEM) at the end of treatment was greater for patients treated with isotretinoin (3.9 +/- 0.6, i.e., 66% of patients with a reduction > 30%) than with placebo (1.7 +/- 0.5, i.e., 45% of patients with a reduction > 30%); this difference was statistically significant (p = 0.001). No significant drug effect was seen for lesions on the scalp or upper extremities. Mild to moderate local reactions with isotretinoin abated with reduced treatment frequency.. Our results suggest that isotretinoin 0.1% cream cannot compete with more rapid treatments of actinic keratoses. However, its effect on facial lesions may be beneficial during long-term treatment of associated sun-damaged skin.

Topics: Administration, Topical; Arm; Double-Blind Method; Facial Dermatoses; Humans; Isotretinoin; Keratosis; Scalp Dermatoses; Sunlight

Dissecting cellulitis (DC) is a chronic inflammatory primary neutrophilic scarring alopecia. It predominantly affects the vertex and occipital regions of Afro-descendent men. Female DC is uncommon, and little is known about this condition in childhood. This paper reports a pediatric female case of DC with an excellent therapeutic response to low-dose oral isotretinoin.

Topics: Alopecia; Cellulitis; Child; Chronic Disease; Female; Humans; Isotretinoin; Scalp Dermatoses

Perifolliculitis capitis abscedens et suffodiens (PCAS) is a rare chronic inflammatory dermatosis of the scalp, which is a refractory and recrudescent disease. Symptoms of PCAS include follicular papules, suppurative nodules, cysts, sinuses, fistulas, and these usually evolve into patchy alopecia or cicatricial alopecia, which seriously affects the beauty and quality of life of patients. In this paper, we report 3 cases of PCAS each of whom received 5% 5-aminolevulinic acid-based photodynamic therapy (ALA-PDT) combined with isotretinoin. Fire needle intervention was used as a pretreatment for ALA-PDT. All pretreatments and ALA-PDT were well tolerated. All patients showed complete clearance of skin lesions and 1 patient attained significant improvement of symptoms after 1 month of treatment. No patients had recurrence with minimum one year follow up. This suggests that topical ALA-PDT pre-treated by fire needle combined with oral isotretinoin could be an eff ;ective, non-invasive, safe method with low recurrence for PCAS.

Topics: Folliculitis; Humans; Isotretinoin; Photochemotherapy; Photosensitizing Agents; Quality of Life; Scalp Dermatoses

Topics: Cellulitis; Humans; Isotretinoin; Scalp Dermatoses

Folliculitis decalvans (FD) is a rare neutrophilic cicatricial alopecia that poses a therapeutic challenge.. To describe the therapeutic response in a large number of cases of FD with long-term follow-up and analyze potential prognostic factors associated with severity of form and with a better therapeutic response.. This multicenter prospective study included patients with FD who had a minimum of 5 years of follow-up. Severity was assessed by the maximum diameter of the cicatricial area. Therapeutic response was evaluated according to stabilization of the size of the cicatricial areas and the improvement in clinical symptoms.. A total of 60 patients (37 men [61.7%] and 23 women [38.3%]) with a mean age of 40 years were included. Earlier age of onset (P = .01) was statistically associated with severity of form. Treatment with rifampicin and clindamycin, tetracyclines, and intralesional steroids was the most effective. No statistically significant prognostic factors predicting a better therapeutic response were found.. Because FD is a rare disease, the main limitation was the sample size.. An earlier age of onset was associated with the severe form of the disease. The proposed specific therapeutic protocol can be a very useful tool in clinical dermatologic practice.

Topics: Adrenal Cortex Hormones; Alopecia; Anti-Bacterial Agents; Cicatrix; Cohort Studies; Combined Modality Therapy; Female; Folliculitis; Follow-Up Studies; Humans; Isotretinoin; Male; Minoxidil; Multivariate Analysis; Photochemotherapy; Retrospective Studies; Risk Assessment; Scalp Dermatoses; Spain; Time Factors; Treatment Outcome

Dissecting folliculitis (DF) or dissecting cellulitis of the scalp is regarded as a rare disease with disfiguring scarring alopecia. This study aimed to analyze the features of DF and to propose a classification to define its severity.. A hospital-based retrospective study was conducted. Patients with a histopathological diagnosis or clinical features leading to diagnosis of DF were included and classified into three stages.. Among the 66 patients recruited (63 men / 3 women, mean age 24.9 years), multiple interconnected alopecic nodules involving the vertex scalp were the main feature. Histopathology showed an extensive inflamed granulation abscess forming a dissection plane in the lower dermis/subcutis in the acute stage. Lymphocytic infiltration was predominant in seven of 21 histology specimens. Overweight and obesity were noted in 29 of 45 patients examined. No association with smoking was found. There was comorbidity with acne conglobata in 15 of 66 patients, two of whom had acne inversa. Longer disease duration and greater number of nodules were associated with higher severity of DF (p < 0.05). A complete remission rate of 25 % was achieved by any treatment, and a rate of 37.5 % was achieved with oral isotretinoin alone.. DF is not uncommon in Taiwan. An association with obesity needs to be clarified.

Topics: Abscess; Acne Vulgaris; Adult; Alopecia; Cellulitis; Comorbidity; Female; Granulation Tissue; Humans; Isotretinoin; Lymphocytosis; Male; Obesity; Overweight; Retrospective Studies; Scalp; Scalp Dermatoses; Skin Diseases, Genetic; Treatment Outcome

An 18-year-old man presented for evaluation of a 1-year history of painful nodules on the scalp with associated hair loss. Physical examination revealed multiple confluent, fluctuant, boggy nodules on the scalp with overlying alopecic patches. Based on these findings, a diagnosis of dissecting cellulitis of the scalp was made and the patient was successfully treated with oral isotretinoin therapy.

Topics: Adolescent; Alopecia; Cellulitis; Humans; Isotretinoin; Male; Scalp; Scalp Dermatoses; Skin Diseases, Genetic

Topics: Adult; Cellulitis; Dermatologic Agents; Drug Eruptions; Drug Substitution; Humans; Isotretinoin; Male; Scalp Dermatoses; Skin Diseases, Genetic; Testosterone Congeners; Treatment Outcome

Topics: Adolescent; Adult; Biopsy; Cellulitis; Dermatologic Agents; Female; Global Health; Humans; Isotretinoin; Male; Middle Aged; Morbidity; Multicenter Studies as Topic; Retrospective Studies; Scalp; Scalp Dermatoses; Skin Diseases, Genetic; Spain; Young Adult

Topics: Adult; Axilla; Dermatologic Agents; Facial Dermatoses; Granuloma; Humans; Isotretinoin; Male; Scalp Dermatoses

Folliculitis decalvans leads to scarring alopecia through inflammatory destruction of the hair follicle. Currently, antibiotics are most commonly used to treat this disease. However, treatment regimens with antibiotics feature a high relapse rate and encourage the development of resistant bacteria.. To evaluate the outcome of different treatment options for folliculitis decalvans.. Retrospective study to compare the efficacy of different treatment regimens in 28 patients with folliculitis decalvans.. The success of treatment with clindamycin and rifampicin, clarithromycin, dapsone and isotretinoin was analysed. The evaluation of the combination of clindamycin and rifampicin showed the lowest success rate in achieving long-term remission, since 80% of the patients relapsed shortly after end of treatment. Clarithromycin and dapsone were more successful with long-term and stable remission rates of 33% and 43% respectively. Treatment with isotretinoin was the most successful oral treatment in our analysis with 90% of the patients experiencing stable remission during and up to two years after cessation of the treatment.. The common use of antibiotics as first-line therapy in folliculitis decalvans needs to be re-evaluated critically and oral isotretinoin should be considered as valid treatment alternative.

Topics: Administration, Oral; Adult; Anti-Bacterial Agents; Clindamycin; Dermatologic Agents; Drug Therapy, Combination; Female; Folliculitis; Follow-Up Studies; Humans; Isotretinoin; Male; Middle Aged; Retrospective Studies; Rifampin; Scalp Dermatoses; Treatment Outcome; Young Adult

Dissecting cellulitis of the scalp is a chronic, relapsing, inflammatory disease of the scalp that results in scarring alopecia. We present a case of a 32-year-old man with recalcitrant disease who is now responding to treatment with isotretinoin. The pathogenesis, clinical presentation, disease associations, and histopathological findings are reviewed. Treatment can be challenging. The literature on medical and surgical therapeutic options is reviewed.

Topics: Adult; Alopecia; Cellulitis; Dermatologic Agents; Humans; Isotretinoin; Male; Methicillin-Resistant Staphylococcus aureus; Scalp Dermatoses; Staphylococcal Infections

Perifolliculitis capitis abscedens et suffodiens or dissecting cellulitis of the scalp is a rare, chronic destructive folliculitis of the scalp, characterized by painful nodules, purulent drainage, sinus tracts, keloid formation and cicatricial alopecia. The cause of the disease is unknown, but it is similar in many features to hidradenitis suppurativa and acne conglobata. In our case report, the patient's dermatologic appearance included one slightly erythematous, infiltrated alopecic area with draining lesions in the right parietal part of the scalp with a few alopecic areas in other parts of the scalp. The identification of the infectious agent, repeated swabs and KOH examination/or fungal cultures and tissue sampling for histopathologic analysis were necessary to confirm the diagnosis of perifolliculitis capitis abscedens et suffodiens. The patient received systemic antibiotics (azithromycin and amoxicillin-clavulanate) and oral antimycotic therapy (fluconazole), followed by a long period of oral isotretinoin with local skin care, which led to resolution and thus inhibited the evolution to scarring and nodular stage of the disease. Thus, such combined approach could be useful for other patients with these dermatologic problems.

Topics: Biopsy, Needle; Dermatologic Agents; Disease Progression; Folliculitis; Follow-Up Studies; Humans; Immunohistochemistry; Isotretinoin; Male; Scalp Dermatoses; Severity of Illness Index; Treatment Outcome; White People

Topics: Administration, Topical; Child; Darier Disease; Dermatologic Agents; Female; Humans; Isotretinoin; Pityriasis; Scalp Dermatoses; Treatment Outcome

Dissecting cellulitis of the scalp, or perifolliculitis capitis abscedens et suffodiens, is an uncommon chronic suppurative disease of the scalp manifested by follicular and perifollicular inflammatory nodules that suppurate and undermine, forming intercommunicating sinuses, and leading to scarring alopecia. Treatment generally fails to obtain a permanently successful result; thus, many therapeutic options have been proposed. We report 4 cases of dissecting cellulitis of the scalp successfully treated with oral rifampicin and oral isotretinoin. To our knowledge, this is the first report of oral rifampicin used concomitantly with oral isotretinoin in this disease entity. We also present a brief review of the literature on the topic.

Topics: Administration, Oral; Adult; Cellulitis; Dermatologic Agents; Diagnosis, Differential; Drug Therapy, Combination; Enzyme Inhibitors; Humans; Isotretinoin; Male; Rifampin; Scalp Dermatoses

Perifolliculitis capitis abscedens et suffodiens (PCAS) is a rare scalp disease of unknown etiology which is hard to treat. It is often accompanied by scarring alopecia, acne conglobata, and recurrent fluctuant abscesses. PCAS belongs to the family of acne inversa (hidradenitis suppurativa). A 19-year-old man presented with PCAS for 2 years; multiple systemic antibiotic therapies and surgical approaches had shown no effect. Monotherapy with isotretinoin 80 mg daily for 4 weeks had not been successful. Combination therapy with dapsone 100 mg and isotretinoin 80 mg daily produced significant improvement. During 4 weeks of treatment significant clearing was achieved. Dapsone was reduced to 50 mg daily after 6 months, while isotretinoin was discontinued gradually. Now the patient is on dapsone 50 mg every other day and has remained free of recurrences for 6 months.

Topics: Adult; Dapsone; Dermatologic Agents; Drug Therapy, Combination; Folliculitis; Humans; Isotretinoin; Male; Scalp Dermatoses; Treatment Outcome

Topics: Aged, 80 and over; Dermatologic Agents; Female; Humans; Isotretinoin; Scalp Dermatoses; Skin Diseases, Vesiculobullous

Topics: Adult; Cellulitis; Chest Pain; Dermatologic Agents; Humans; Isotretinoin; Male; Recurrence; Scalp Dermatoses

Topics: Adult; Cellulitis; Dermatologic Agents; Humans; Isotretinoin; Male; Scalp Dermatoses

Topics: Adult; Anti-Bacterial Agents; Cellulitis; Clindamycin; Dermatologic Agents; Humans; Isotretinoin; Male; Peptostreptococcus; Prevotella intermedia; Scalp Dermatoses

Folliculitis decalvans of the scalp is a recurrent, purulent follicular inflammation leading to scarring alopecia. We report on a 27-year-old man with folliculitis decalvans successfully treated with a combination of isotretinoin, corticosteroids, and clindamycin.

Topics: Administration, Oral; Adult; Clindamycin; Dermatologic Agents; Drug Therapy, Combination; Folliculitis; Humans; Isotretinoin; Male; Prednisolone; Scalp Dermatoses; Staphylococcal Infections

A 27-year-old man presented with a 10-year history of scarring alopecia on the vertex of the scalp associated with follicular crusting and pustule formation, and a papular eruption on the posterior neck. Additionally, there was keratosis pilaris on the cheeks, eyebrows and thighs. Histology from the vertex showed scarring with a mixed perifollicular inflammatory infiltrate and foci of acute suppurative folliculitis. With clinical correlation, the diagnosis of keratosis follicularis spinulosa decalvans and concurrent acne keloidalis nuchae was made. The association of keratosis follicularis spinulosa decalvans with acne keloidalis nuchae has not previously been described. The patient responded to treatment with oral isotretinoin 20 mg (0.25 mg/kg) daily for 12 months.

Topics: Acne Keloid; Adult; Alopecia; Anti-Bacterial Agents; Anti-Inflammatory Agents; Darier Disease; Eyebrows; Humans; Isotretinoin; Male; Neck; Scalp Dermatoses; Treatment Outcome

Topics: Abscess; Adult; Folliculitis; Humans; Isotretinoin; Male; Scalp Dermatoses; Staphylococcal Infections

Topics: Adult; Cellulitis; Dermatologic Agents; Humans; Isotretinoin; Male; Scalp Dermatoses; Treatment Outcome

Topics: Adult; Cellulitis; Drug Administration Schedule; Humans; Isotretinoin; Keratolytic Agents; Male; Remission Induction; Scalp Dermatoses; Treatment Outcome

A patient with arthropathy associated with cystic acne, hidradenitis suppurativa, and perifolliculitis capitis abscedens et suffodiens who showed a dramatic response to isotretinoin is described. This, to our knowledge, is the first report documenting effective treatment of this condition, whose nosologic position with respect to other spondyloarthropathies associated with cutaneous disease is considered.

Topics: Acne Vulgaris; Acquired Hyperostosis Syndrome; Adult; Arthritis; Hidradenitis Suppurativa; Humans; Isotretinoin; Keratolytic Agents; Male; Scalp Dermatoses

Isotretinoin, an effective therapy for nodulocystic acne and dissecting cellulitis of the scalp, has many known side effects. However, its association with elevated creatine kinase levels and its potential to cause rhabdomyolysis is not well established. We describe a patient with a significant elevation in creatine kinase after beginning therapy with isotretinoin for dissecting cellulitis of the scalp. The implications of isotretinoin causing rhabdomyolysis are discussed.

Topics: Cellulitis; Humans; Isotretinoin; Male; Middle Aged; Rhabdomyolysis; Scalp Dermatoses

A 27-year-old male patient presented with scaly erythema and crusts on the scalp. Since birth, he suffered from dry skin and inflammation of the eyelids. Scarring alopecia was noticed in some regions of his scalp. Folliculitis spinulosa decalvans was diagnosed. Therapy with isotretinoin and topical corticosteroids was without effect. In contrast, 100 mg of Dapsone per day led to resolution of the inflammatory signs. This enabled him to cover the disfiguring scarring alopecia with a permanent hairpiece. His condition has been stable after 18 months without the enlargement of the scarred alopecic areas.

Topics: Adrenal Cortex Hormones; Adult; Alopecia; Anti-Inflammatory Agents, Non-Steroidal; Blepharitis; Cicatrix; Dapsone; Erythema; Folliculitis; Follow-Up Studies; Humans; Isotretinoin; Keratolytic Agents; Male; Scalp Dermatoses; Skin Diseases; Treatment Outcome

We report three patients with dissecting cellulitis of the scalp. Prolonged treatment with oral isotretinoin was highly effective in all three patients. Furthermore, long-term post-treatment follow-up in two of the patients has shown a sustained therapeutic benefit.

Topics: Adult; Black or African American; Cellulitis; Follow-Up Studies; Humans; Isotretinoin; Keratolytic Agents; Male; Scalp Dermatoses

Topics: Administration, Oral; Cell Nucleus; Cytoplasm; Facial Dermatoses; Follow-Up Studies; Histiocytes; Histiocytosis, Langerhans-Cell; Humans; Isotretinoin; Male; Middle Aged; Remission Induction; Scalp Dermatoses

Perifolliculitis capitis abscedens et suffodiens is a rare, chronic and suppurative scalp disease. The treatment of this condition is difficult. CASE REPORT. We report a case successfully treated with isotretinoin at the dose of 2/3 mg/kg/day during eight month. DISCUSSION. The main difficulty is the maintenance of remission after drug withdrawal, so, duration of treatment has to be defined. A eight month's therapy seems to constitute the minimum duration in this pathology. A second course of isotretinoin is still possible if relapse occurs. CONCLUSION. A long course of isotretinoin can be considered as the most effective treatment in perifolliculitis capitis abscedens et suffodiens.

Topics: Adult; Folliculitis; Humans; Isotretinoin; Male; Scalp Dermatoses; Suppuration; Treatment Outcome

This is a case report of four patients of the same family with pachyderma. Their clinical findings are discussed in regard of a review of the literature. Also, because there are few data on effective treatment, their dramatic improvement with isotretinoin is of significant interest.

Topics: Adult; Aged; Female; Humans; Hypertension; Hypertriglyceridemia; Isotretinoin; Male; Osteoarthropathy, Primary Hypertrophic; Pedigree; Scalp Dermatoses; Skin Diseases

Topics: Abscess; Adult; Alopecia; Folliculitis; Humans; Isotretinoin; Male; Scalp Dermatoses; Suppuration

Topics: Adult; Drug Therapy, Combination; Folliculitis; Humans; Isotretinoin; Male; Scalp Dermatoses; Triamcinolone Acetonide

Dissecting folliculitis of the scalp can develop into an extensive, hypertrophic scarred lesion that is unresponsive to routine treatment. In these situations, radical excision of the affected area and concurrent perioperative treatment with isotretinoin (13-cis-retinoic acid) may be effective. The authors describe a case, illustrating the successful clinical application of this technique.

Topics: Adult; Alopecia; Combined Modality Therapy; Folliculitis; Follow-Up Studies; Humans; Isotretinoin; Male; Scalp; Scalp Dermatoses; Surgical Flaps; Tissue Expansion

Topics: Adult; Cellulitis; Family Health; Humans; Isotretinoin; Male; Scalp Dermatoses; Staphylococcal Infections

Acne keloidalis nuchae is characterized by keloidal papules and plaques. The lesions are located on the occipital scalp and posterior neck. This rare therapy-resistant condition is nearly always seen in men, particularly in negroes. Advanced stages of the disease require surgical excision with split-thickness skin grafts or treatment with a CO2 laser. Oral therapy with 13-cis-retinoic acid (isotretinoin) in a 23-year-old white man resulted in remarkable improvement within a few weeks.

Topics: Administration, Oral; Adult; Chronic Disease; Dose-Response Relationship, Drug; Folliculitis; Humans; Isotretinoin; Male; Scalp Dermatoses; Skin

Topics: Adult; Cellulitis; Humans; Isotretinoin; Male; Scalp Dermatoses; Tretinoin

Topics: Adult; Folliculitis; Humans; Isotretinoin; Male; Scalp Dermatoses; Tretinoin