A 20-year-man referred for cystic masses on his scalp. The disease began about 3 months earlier with painful discharging nodules . The lesions progressed and hairs shed rapidly in spite of using systemic antibiotics. He had a past history for acne. Smear and culture of abscess material was negative...

 What is your diagnosis?

Diagnosis: Perifolliculitis Capitis abscedens et suffodiens

Perifolliculitis capitis, also known as dissecting cellulitis, is a rare, chronic, progressive and suppurative disease of the scalp.

It ocuurs primarily between the ages of 18 and 40 and almost exclusively in men, and is more common in black than white men. Painful, boggy, sterile abscesses form on the scalp and with disease progression, scarring and alopecia are seen, and keloid may form.

The cause is unknown and systemic antibiotics provide only partial relief. Isotretinoin, oral zinc sulphate and oral prednisone reported to be effective in this disease.