SCOPUS
KCI등재
Linear Dissecting Cellulitis Successfully Treated with Simple Excision = Linear Dissecting Cellulitis Successfully Treated with Simple Excision
저자
( Noo Ri Lee ) ; ( Jaewoong Choi ) ; ( Won-soo Lee ) 연구자관계분석
발행기관
학술지명
권호사항
발행연도
2017
작성언어
Korean
주제어
등재정보
SCOPUS,KCI등재
자료형태
학술저널
발행기관 URL
수록면
151-153(3쪽)
제공처
소장기관
Dissecting cellulitis of the scalp (DCS), also known as perifolliculitis capitis abscedens et suffodiens, (Hoffman) is a rare disease characterized by perifollicular pustules, painful nodules, abscesses, and sinus tracts that eventually evolve into keloid formation and scarring alopecia<sup>1</sup>. Multiple treatment options are reported; however, no cure is available. We report a case of dissecting cellulitis with unusual linear morphology, which was successfully treated with surgery. A 48-year-old man visited our department with a 2-month history of hairless skin-colored nodules on his occipital scalp. He had diabetes mellitus and hypertension for 10 years and 1 year, respectively, and has been taking medications. Further, he underwent thyroidectomy for a thyroid nodule 6 years prior. By physical examination, it was observed that there were skin-colored nodules arranged linearly on his lower occipital scalp with a loss of follicular openings (Fig. 1A). The patient complained tenderness of the lesion and recalled no trauma to the occipital site. The lesions were fluctuant by palpitation. The X-ray finding of the skull showed no gross bony abnormality. Complete blood count, serum biochemistry profile, and electrolytes were all within normal ranges; however, (+) glucose was detected in his urine analysis. Bacterial culture from pus obtained during biopsy revealed rare Staphylococcus intermedius, and the patient was administered cefpodoxime orally for 2 weeks. Histopathologic features showed mild follicular plugging and perifollicular inflammatory infiltration composed of lymphocytes, histiocytes, and plasma cells (Fig. 2A∼C). As the lesion localized only on the occipital scalp, the patient was referred to a plastic surgeon for complete excision of the lesion. The entire lesion was successfully removed with simple excision, and primary repair was performed (Fig. 1B). After the excision, oral cefpodoxime was administered for only 1 week. Histological findings of the excised specimen revealed deep and extensive suppurative inflammation composed of lymphocytes, plasma cells, and foreign bodytype giant cells (Fig. 2D∼F). For 2 years of follow-up after surgery, no recurrence of the disease occurred (Fig. 1C). DCS is occasionally reported in African Americans and seen rarely in Caucasians. It is reported in association with HS, acne conglobate, and pilonidal cysts as the follicular occlusion tetrad. Although abscesses are usually sterile, bacteriologic analyses from draining pus sometimes reveal numerous pathogenic and nonpathogenic organisms<sup>1</sup>. It is generally believed that a bacterial infection is only a secondary event rather than a main pathogenic factor. Various treatment options for DCS are reported. Oral retinoids, including isotretinoin, acitretin, oral antibiotics, prednisone, intralesional glucocorticoid, laser, and photodynamic therapy, are reported to be effective, although most of the reports are based on small series or case reports. Oral alitretinoin, tumor necrosis factor blockers, oral zinc, and external beam radiation therapy are newly proposed therapies<sup>1</sup>. For whom medical therapy fails to bring improvement, surgery is needed. Previous reports described DCS involving the whole scalp, which was refractory to the outcomes of other treatments, and successfully treated with complete scalp excision followed by split-thickness skin grafting2. However, there is also a report of recurred DCS at the site of the surgical scar after surgical excision<sup>3</sup>; thus, a long-term follow-up is mandatory. In our case, the lesion was successfully removed by simple excision and oral anti-biotics and showed no recurrence for 2 years but still needed regular examinations. The pathogenesis of DCS is still unclear. To date, follicular dysfunction and aberrant cutaneous immune response to commensal bacteria are proposed as the common path-ogenesis for DCS and other follicular occlusive diseases<sup>1</sup>. A study by Sayed et al. suggested harsh trauma to the scalp that causes cutaneous irritation as a possible trigger for DCS<sup>4</sup>. The skin lesion in our case was localized to the lower occipital scalp and showed an unusual linear distribution. There was no definite history of trauma to the scalp. Obesity of the patient may have caused the occipital scalp to be folded in a linear pattern, or the patient`s habitual behavior, such as touching or scratching his nape, could have been a repeated stimulus that led to chronic occlusion and destruction of the hair follicles, followed by secondary infection. The linear morphologic pattern of DCS has never been reported in English literature, and linear arrangement of other inflammatory scalp diseases, such as tufted hair folliculitis, has been reported<sup>5</sup>. Owing to the linearity and well-localized features of DCS in our case, the lesion could be accurately excised with no recurrence during the long-term follow-up even when the patient did not receive any systemic medications after surgery. This present case proposes surgical treatment as an optimal option for DCS with localized distribution. We also suggest that chronic physical stimuli may be a possible triggering factor in the pathogenesis of DCS.
더보기분석정보
서지정보 내보내기(Export)
닫기소장기관 정보
닫기권호소장정보
닫기오류접수
닫기오류 접수 확인
닫기음성서비스 신청
닫기음성서비스 신청 확인
닫기이용약관
닫기학술연구정보서비스 이용약관 (2017년 1월 1일 ~ 현재 적용)
학술연구정보서비스(이하 RISS)는 정보주체의 자유와 권리 보호를 위해 「개인정보 보호법」 및 관계 법령이 정한 바를 준수하여, 적법하게 개인정보를 처리하고 안전하게 관리하고 있습니다. 이에 「개인정보 보호법」 제30조에 따라 정보주체에게 개인정보 처리에 관한 절차 및 기준을 안내하고, 이와 관련한 고충을 신속하고 원활하게 처리할 수 있도록 하기 위하여 다음과 같이 개인정보 처리방침을 수립·공개합니다.
주요 개인정보 처리 표시(라벨링)
목 차
3년
또는 회원탈퇴시까지5년
(「전자상거래 등에서의 소비자보호에 관한3년
(「전자상거래 등에서의 소비자보호에 관한2년
이상(개인정보보호위원회 : 개인정보의 안전성 확보조치 기준)개인정보파일의 명칭 | 운영근거 / 처리목적 | 개인정보파일에 기록되는 개인정보의 항목 | 보유기간 | |
---|---|---|---|---|
학술연구정보서비스 이용자 가입정보 파일 | 한국교육학술정보원법 | 필수 | ID, 비밀번호, 성명, 생년월일, 신분(직업구분), 이메일, 소속분야, 웹진메일 수신동의 여부 | 3년 또는 탈퇴시 |
선택 | 소속기관명, 소속도서관명, 학과/부서명, 학번/직원번호, 휴대전화, 주소 |
구분 | 담당자 | 연락처 |
---|---|---|
KERIS 개인정보 보호책임자 | 정보보호본부 김태우 | - 이메일 : lsy@keris.or.kr - 전화번호 : 053-714-0439 - 팩스번호 : 053-714-0195 |
KERIS 개인정보 보호담당자 | 개인정보보호부 이상엽 | |
RISS 개인정보 보호책임자 | 대학학술본부 장금연 | - 이메일 : giltizen@keris.or.kr - 전화번호 : 053-714-0149 - 팩스번호 : 053-714-0194 |
RISS 개인정보 보호담당자 | 학술진흥부 길원진 |
자동로그아웃 안내
닫기인증오류 안내
닫기귀하께서는 휴면계정 전환 후 1년동안 회원정보 수집 및 이용에 대한
재동의를 하지 않으신 관계로 개인정보가 삭제되었습니다.
(참조 : RISS 이용약관 및 개인정보처리방침)
신규회원으로 가입하여 이용 부탁 드리며, 추가 문의는 고객센터로 연락 바랍니다.
- 기존 아이디 재사용 불가
휴면계정 안내
RISS는 [표준개인정보 보호지침]에 따라 2년을 주기로 개인정보 수집·이용에 관하여 (재)동의를 받고 있으며, (재)동의를 하지 않을 경우, 휴면계정으로 전환됩니다.
(※ 휴면계정은 원문이용 및 복사/대출 서비스를 이용할 수 없습니다.)
휴면계정으로 전환된 후 1년간 회원정보 수집·이용에 대한 재동의를 하지 않을 경우, RISS에서 자동탈퇴 및 개인정보가 삭제처리 됩니다.
고객센터 1599-3122
ARS번호+1번(회원가입 및 정보수정)