Treatment of dissecting cellulitis of the scalp with tumour necrosis factor inhibitors: a retrospective multicentre study.

Although retinoids are considered as the most effective treatment, management of dissecting cellulitis of the scalp (DCS) is often challenging. A multicentre retrospective study was conducted to evaluate the efficacy of anti-tumour necrosis factor (TNF) agents in treating DCS after failure of other conventional treatments. Twenty-six patients were included. After a mean treatment duration of 19 months (SD 21), the median Physician's Global Assessment score decreased from 3 to 1. The median number of inflammatory nodules and abscesses decreased from 7 to 0.5 and from 1 to 0, respectively. The median Dermatology Life Quality Index and numerical rating scale score for pain severity decreased from 10 to 8 and 6 to 1, respectively. The median treatment satisfaction was 7 out of 10 on the Patient Satisfaction Index. This study confirms the efficacy of anti-TNF agents in treating patients with DCS that is resistant to conventional therapies.

Pyoderma Gangrenosum as Differential Diagnosis to Post-Operative Infection after Breast Plastic Surgery.

Background: Pyoderma gangrenosum is a scarce ulcerating inflammatory skin disease, which requires excluding other causes of ulceration such as infections, malignancies or connective tissue diseases. Case Report: We report the case of a 38-year-old woman who developed a progressive bilateral breast skin ulcer after breast plastic surgery, suspected initially with an early postoperative infection. The lack of improvement despite adequate antimicrobial drugs conducted to perform a skin biopsy, concluding to an ulcerated neutrophil dermatosis which led to the diagnosis of postoperative pyoderma gangrenosum. The clinical course was favorable with a systemic treatment based on steroids. Conclusions: In order to prevent debridement and extension of local complications, this case report illustrates the importance to suspect pyoderma gangrenosum as differential diagnosis of infection after surgery.