Dissecting Cellulitis: A Closer Look at Smoking As a Risk Factor

Smoking May Be a Risk Factor for Dissecting Cellulitis

Dissecting cellulitis (DCS) s a type of neutrophilic scarring alopecia. Patients with DSC present with soft boggy nodules on the scalp and draining sinuses. These areas may become scarred leaving permanent hair loss. Some patients with DSC have the so called follicular occlusion “tetrad” which includes dissecting cellulitis, hidradenitis suppurativa (boil like lesions in the armpits and groin), acne conglobata (a severe acne on the face and back and chest) and pilonidal cysts (cysts in the buttocks area in the gluteal cleft).

A Search For Risk Factors in DSC

Smoking and obesity are known risk factors for hidradenitis suppurativa. Given how closely DSC is related in HS, researchers from New Orleans set out to evaluate whether smoking and obesity are also risk factors for DSC.

The researchers evaluated 33 DSC patients and 304 controls. The control group was a group of patients with keloids. he mean age of DSC patients was 39.6 years compared to 44.4 years in the controls (p=0.05). 87.9 % of DSC patients were women compared to 33 % of controls.

Smoking was more common in DSC patients than controls. 39.4 % of DSC patients in this study were current smokers and 21.2 % were former smokers. This was higher than in controls. IN fact, DSC patients were 6.5 times more likely to be current smokers. There was no clear associated with obesity although 21.2 % of DSC patients were overweight and 48.5 % were obese.

Conclusion

This study suggests that smoking is also a risk factor for DSC.

REFERENCE

Tran et al. Risk factors for dissecting cellulitis of the scalp: A case-control study. J Am Acad Dermatol. . 2021 Mar 27;S0190-9622(21)00635-6.