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New research · Dermatology
Clinical, cosmetic and investigational dermatology · 1d
Cohort studyClinical, cosmetic and investigational dermatology · 2026

Perifollicular Lymphocytic Inflammation and Fibrosis in Dissecting Cellulitis: Evidence of a Consistent Histopathologic Pattern.

Sanusi Umar, Ochanya Ogah, Jason Yang … Paul K Shitabata
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DermatologyCohort study

Perifollicular inflammation and fibrosis was found in all normal-appearing scalp biopsies in dissecting cellulitis.

Perifollicular Lymphocytic Inflammation and Fibrosis in Dissecting Cellulitis: Evidence of a Consistent Histopathologic Pattern.

Sanusi Umar et al. · Clinical, cosmetic and investigational dermatology · 2026
Purpose

Dissecting cellulitis of the scalp (DCS) is a chronic, relapsing, suppurative primary cicatricial alopecia.

Methods

Underwent trichoscopy-guided 6-mm punch biopsy of cNAS and a second biopsy of an active lesion or inactive nodule.

Results
inflammation and scarring around hair follicles was present in every normal-looking scalp biopsy
More results

Active lesions (9/9) showed suppurative inflammation and remodeling superimposed on PIILIF (infundibulo-isthmic fibrosis, 9/9; lymphocytes, 8/9), with increased neutrophilic infiltrates (9/9 vs 0/9 in matched cNAS; adjusted P<0.001), granulation tissue (5/9 vs 0/9; adjusted P=0.035), and complete sebaceous gland loss (6/9 vs 0/9; adjusted P=0.012).

More results

Infiltrates were CD4-predominant with prominent CD117-positive mast cells.

PIILIF was observed in a sideburn biopsy in one patient, and 3 patients (25%) had concurrent histologic acne keloidalis nuchae.

“
Conclusion · 1 of 2

In this small cohort, PIILIF was consistently observed in cNAS and inactive nodules from patients with DCS, while active lesions showed additional suppurative destruction.

Conclusion · 2 of 2

These findings support the hypothesis that PIILIF may represent a subclinical histopathologic component of DCS. Prospective controlled studies are needed to determine specificity, temporal sequence, and prognostic significance.

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