Dissecting cellulitis treated with the long-pulsed Nd:YAG laser.

BACKGROUND

Dissecting cellulitis is a chronic inflammatory scalp condition characterized by pustular nodules, sinus tract formation, and resultant cicatricial alopecia. Current treatments are of limited efficacy.

OBJECTIVE

This report explored treating dissecting cellulitis with the long-pulsed Nd:YAG laser to determine the capabilities and limitations of this modality with respect to: (1) reducing pus formation; (2) enabling the termination of systemic treatments; (3) investigating the side-effect profile including dyspigmentation and scarring alopecia; and (4) terminating the disease process.

METHODS

This observational study followed four patients with long-standing dissecting cellulitis through consecutive treatments with the long-pulsed Nd:YAG laser without epidermal cooling.

RESULTS

One year after initiating laser treatment, patients achieved decreased pus formation, a reduced reliance on systemic treatments, and a controlled or terminated disease process without dyspigmentation. Three patients had regrowth of terminal hairs in treatment sites.

CONCLUSION

The long-pulsed Nd:YAG laser is effective in attenuating the progression of dissecting cellulitis without appreciable adverse cutaneous side effects. This is a pilot study, and more patients must be treated in other trials to verify these findings.