Excellent Response to Oral Isotretinoin in a Pediatric Patient With Dissecting Cellulitis of the Scalp

Dissecting cellulitis of the scalp (DCS) is a rare, chronic inflammatory scalp disorder that is characterized by painful, recurrent nodules, abscesses, fistulas, and sinus tracts that can lead to scarring alopecia. We present the case of an 11-year-old Black female with painful, pruritic scalp nodules and hair loss of several months' duration. The patient's clinical and histopathologic presentation was consistent with DCS. After failure to improve with numerous oral/topical antibiotics and topical/intra-lesional corticosteroid therapies, the patient achieved an excellent clinical response to oral isotretinoin. The treatment of DCS remains a challenge for dermatologists due to the lack of standardized, evidence-based guidelines. Given the complexity of treating DCS, especially in the pediatric population, raising awareness for effective management options may lead to enhanced patient outcomes.