Dissecting cellulitis of the scalp treated by tumour necrosis factor inhibitors: a case series

Background Dissecting cellulitis of the scalp (DCS), also known as Hoffmann disease or perifolliculitis capitis abscedens et suffodiens, is a rare disease characterized by chronic inflammation of the scalp. Treatment is difficult and often disappointing. Objectives To report our experience of TNF inhibitors in a series of patients with DCS. Materials & Methods We conducted a monocentric retrospective study of nine patients with DCS treated with TNF blocker after failure of other conventional treatments. Results After a mean duration of treatment by TNF inhibitors of 17 +/- 16 months, four patients (44% versus 0%) had a Physician's Global Assessment score of 0 or 1. We observed a 67% reduction in the number of inflammatory nodules, an 88% reduction in purulent drainage and a 45% improvement in Dermatology Life Quality Index. The mean treatment satisfaction index was 6.6 +/- 1.6 out of 10. Conclusion Our study suggests that TNF inhibitors are effective against disease activity and may improve quality of life in the management of DCS refractory to conventional treatments.