Sinus tracts in Dissecting Cellulitis

Dissecting Cellulitis (DSC)

DSC is a rare scarring alopecia. It often affects young men. A key feature is boggy tender nodules that develop in the scalp, some of which drain pus. "Sinus tracts" are another feature and this refers to the presence of small tunnels that interconnect under the scalp.

This photo shows the appearance of one such "sinus tract" after it has entered a healing phase. This area will be permanently scarred with some degree of permanent hair loss in this area.

Treatment for DSC includes isotretinoin, antibiotics, TNF inhibitors. Second line agents include zinc, dapsone, colchicine. Surgical excision and laser therapies are also considerations. Some forms are challenging to treat.

For more information on DSC, see our Dissecting Cellulitis Handout for Patients