Trichoscopy findings in dissecting cellulitis

Dissecting cellulitis is an inflammatory, chronic, and recurrent disease of the hair follicles that mainly affects young Afro-descendent men. Trichoscopy is a method of great diagnostic value for disorders of the scalp. Clinical and trichoscopic findings of dissecting cellulitis are heterogeneous and may present features common to non-cicatricial and scarring alopecia. This article presents the trichoscopic findings of dissecting cellulitis that help in the diagnosis and consequent institution of the appropriate therapy and better prognosis of the disease.

KEYWORDS
Alopecia; Cellulitis; Dermoscopy; Folliculitis; Hair; Scalp dermatoses

Authorship

Daniel Fernandes Melo

Alopecia Outpatient Clinic, Hospital Naval Marcílio Dias, Rio de Janeiro, RJ, BrazilHospital Naval Marcílio DiasBrazilRio de Janeiro, RJ, BrazilAlopecia Outpatient Clinic, Hospital Naval Marcílio Dias, Rio de Janeiro, RJ, Brazil

https://orcid.org/0000-0002-8807-2556

Erica Bertolace Slaibi

https://orcid.org/0000-0003-1375-0452

Thais Marques Feitosa Mendes Siqueira ^** Corresponding author. E-mail:thathamfm@gmail.com (T.M. Siqueira).

https://orcid.org/0000-0003-1666-0903

Violeta Duarte Tortelly

https://orcid.org/0000-0002-9528-1284

* Corresponding author. E-mail:thathamfm@gmail.com (T.M. Siqueira).

Conflicts of interest

The authors declare no conflicts of interest.

Author's contribution

Daniel Fernandes Melo: Approval of the final version of the manuscript; conception and planning of the study; elaboration and writing of the manuscript; obtaining, analyzing and interpreting the data; effective participation in research orientation; intellectual participation in propaedeutic and/or therapeutic conduct of the cases studied; critical review of the literature; critical review of the manuscript.

Erica Bertolace Slaibi: Elaboration and writing of the manuscript; critical review of the literature; critical review of the manuscript.

Thais Marques Feitosa Mendes Siqueira: Elaboration and writing of the manuscript; critical review of the literature; critical review of the manuscript.

Violeta Duarte Tortelly: Approval of the final version of the manuscript; conception and planning of the study; elaboration and writing of the manuscript; obtaining, analyzing and interpreting the data; effective participation in research orientation; intellectual participation in propaedeutic and/or therapeutic conduct of the cases studied; critical review of the literature; critical review of the manuscript.

SCIMAGO INSTITUTIONS RANKINGS

Figures | Tables

Figures (4)
Tables (1)

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Figure 1
(A) “3D” yellow dot (blue arrow), polytrichia (red arrow), and yellow areas (green arrow). (B) Amorphous white area (blue arrow), large brown dots (red arrow), diffuse erythema (green arrow), perifollicular scales (yellow arrow). Trichoscopy performed with 3Gen DermLite® II Hybrid M with polarized light and interface liquid (A) and without interface liquid (B) (alcohol 70%); ×20 magnification.

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Figure 2
(A) Broken hairs (blue arrow), short regrowing hairs (red arrow), black dots (green arrow), large brown dots (yellow arrow), follicular pustules (black arrow), interfollicular erythema (white arrow), and empty follicular openings (gray arrow). (B) Skin clefts with emergent hairs (blue arrow), yellow dots (red arrow), “3D” yellow dots (green arrow), and peri- and interfollicular erythema (yellow arrow). Trichoscopy performed with 3Gen DermLite® II Hybrid M with polarized light with interface liquid (alcohol 70%); ×20 magnification.

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Figure 3
(A) Hematic crust (blue arrow) and erythematous-yellowish area (red arrow). (B) Yellow dots (blue arrow), short regrowing hairs (red arrow), and interfollicular erythema (green arrow). Trichoscopy performed with 3Gen DermLite® II Hybrid M with polarized light and with interface liquid (alcohol 70%); ×20 magnification.

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Figure 4
(A) Red dots (blue arrow), peri- and interfollicular erythema (red arrow), and perifollicular gray-blue pigmentation (green arrow). (B) Black dots (blue arrow), exclamation mark, and dystrophic hairs (red arrow) and pustule (green arrow) Trichoscopy performed with 3Gen DermLite® II Hybrid M with polarized light and with interface liquid (70% alcohol); ×20 magnification.

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Table 1
Trichoscopic findings of dissecting cellulitis.

Figure 1 (A) “3D” yellow dot (blue arrow), polytrichia (red arrow), and yellow areas (green arrow). (B) Amorphous white area (blue arrow), large brown dots (red arrow), diffuse erythema (green arrow), perifollicular scales (yellow arrow). Trichoscopy performed with 3Gen DermLite® II Hybrid M with polarized light and interface liquid (A) and without interface liquid (B) (alcohol 70%); ×20 magnification.

Figure 2 (A) Broken hairs (blue arrow), short regrowing hairs (red arrow), black dots (green arrow), large brown dots (yellow arrow), follicular pustules (black arrow), interfollicular erythema (white arrow), and empty follicular openings (gray arrow). (B) Skin clefts with emergent hairs (blue arrow), yellow dots (red arrow), “3D” yellow dots (green arrow), and peri- and interfollicular erythema (yellow arrow). Trichoscopy performed with 3Gen DermLite® II Hybrid M with polarized light with interface liquid (alcohol 70%); ×20 magnification.

Figure 3 (A) Hematic crust (blue arrow) and erythematous-yellowish area (red arrow). (B) Yellow dots (blue arrow), short regrowing hairs (red arrow), and interfollicular erythema (green arrow). Trichoscopy performed with 3Gen DermLite® II Hybrid M with polarized light and with interface liquid (alcohol 70%); ×20 magnification.

Figure 4 (A) Red dots (blue arrow), peri- and interfollicular erythema (red arrow), and perifollicular gray-blue pigmentation (green arrow). (B) Black dots (blue arrow), exclamation mark, and dystrophic hairs (red arrow) and pustule (green arrow) Trichoscopy performed with 3Gen DermLite® II Hybrid M with polarized light and with interface liquid (70% alcohol); ×20 magnification.

Table 1 Trichoscopic findings of dissecting cellulitis.

01	Broken hair	11	Yellowish, hematic crusts
02	Black dots	12	Large brown dots
03	Exclamation mark hairs	13	Polytrichia
04	Circular hairs	14	Cutaneus clefts with emerging hairs
05	Yellow dots	15	White dots
06	3D yellow dots (soap bubble)	16	Amorphous white areas
07	Empty follicular openings	17	Blue-gray dots
08	Peri- and interfollicular scales	18	Punctate vessels
09	Erythema	19	Red dots
10	Pustules and structureless yellow areas	20	Short regrowing hairs

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[1] * Corresponding author. E-mail:thathamfm@gmail.com (T.M. Siqueira).