This completes our week long look at a scarring hair loss condition known as dissecting cellulitis or "DSC" (also known by the rather long name perifolliculitis capitis abscedens and suffodiens of Hoffman). Dissecting cellulitis more commonly affects young men in their 20s. Black and Hispanic men are most commonly affected. Affected patients first develop tender pimples and lumps in the scalp (papules and nodules) that ultimately break down to give areas that drain pus and sometimes blood. Multiple areas of the scalp can be affected and often form interconnected tracts and tunnels underneath the skin (called sinus tracts). Despite all the pus, most patients do not grow any bacteria when samples are submitted for culture. The cause of DSC is not known. It is thought that the primary problem exists in the hair follicle wall and faulty keratinization of the wall leads to skin breakdown and secondary infection. Therefore despite looking like a chronic infection, DSC is not primarily due to bacteria. Because the primary problem is in keratinization, the primary treatment for DSC is isotretinoin. Other treatments are discussed in posts that follow. #dissectingcellulitis #scarringalopecia #hair #hairloss #hairlosseducation #hairclinic