Successful treatment of recalcitrant dissecting cellulitis of the scalp with complete scalp excision and split-thickness skin graft.

BACKGROUND: Dissecting cellulitis of the scalp (DCS) is a therapeutically challenging, chronic, progressive, suppurative disease of the scalp that is of unknown etiology. In addition to causing considerable discomfort and cosmetic disfigurement, long-standing lesions may result in the development of squamous cell carcinoma. Several treatment modalities for DCS have been employed with variable results.

OBJECTIVE: To report the successful treatment of an aggressive, refractory case of DCS with complete scalp excision and split-thickness skin graft.

METHODS: A 25-year-old black male with DCS was treated with complete scalp excision and split-thickness graft from the anterior thighs.

RESULTS: The patient has remained free of disease activity and is satisfied with the cosmetic result.

CONCLUSION: Complete scalp excision with split-thickness skin graft may be curative in patients with DCS and should be considered in recalcitrant cases that fail to respond to medical therapy.