ArticleClinical, cosmetic and investigational dermatology2026
Perifollicular Lymphocytic Inflammation and Fibrosis in Dissecting Cellulitis: Evidence of a Consistent Histopathologic Pattern.
Article in Clinical, cosmetic and investigational dermatology, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
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Who cites it
1 citing paper in PubMed.
- A Candidate Syndromic Triad of Acne Keloidalis Nuchae, Dissecting Cellulitis, and Secondary Cutis Verticis Gyrata.Clinical, cosmetic and investigational dermatology · 2026Article
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Authors and funding
6 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
Purpose: Dissecting cellulitis of the scalp (DCS) is a chronic, relapsing, suppurative primary cicatricial alopecia. Perifollicular infundibulo-isthmic lymphocytic inflammation and fibrosis (PIILIF) occurs in clinically normal-appearing scalp (cNAS) in other primary cicatricial alopecias but has not been systematically evaluated in DCS. Patients and Methods: In this retrospective exploratory study, we reviewed consecutive patients with clinicopathologically concordant DCS evaluated at a single Los Angeles dermatology clinic from December 2022 to November 2024. Patients underwent trichoscopy-guided 6-mm punch biopsy of cNAS and a second biopsy of an active lesion or inactive nodule. Specimens were processed with vertical and transverse sections and independently reviewed by two blinded board-certified dermatopathologists. CD4, CD8, CD117, and, when needed, α-smooth muscle actin immunostaining supported characterization. Exact tests with false-discovery-rate adjustment were exploratory. Results: Twelve men were included (mean age, 30 years; range, 21-46 years). PIILIF was identified in all cNAS biopsies (12/12; 100%; exact 95% CI, 73.5-100%) and all inactive nodules (3/3). 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). 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: In this small cohort, PIILIF was consistently observed in cNAS and inactive nodules from patients with DCS, while active lesions showed additional suppurative destruction. 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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