Alopecic and Aseptic Nodules of the Scalp: A New Entity or a Minor Form of Dissecting Cellulitis?

Overview

Journal Int J Trichology

Date 2022 Sep 9

PMID 36081440

Authors

Ngoc-Nhi Catharina Luu

Natalia Caballero Uribe

Maria Fernanda Reis Gavazzoni Dias

Hudson Dutra Rezende

Ralph Michel Trueb

Affiliations

Soon will be listed here.

Abstract

Since the original report in 1992 and revised nomenclature in 2009, pseudocysts of the scalp and alopecic and aseptic nodules of the scalp (AANS), respectively, have been regarded as a new entity that is rare and not understood in its pathogenesis. We observed 26 cases of AANS. Except for the extent and severity of disease, we found no single feature that justifies distinguishing AANS as a nosologic entity in its own right from dissecting cellulitis of the scalp (DCS). The scarring alopecias represent a diverse group of disorders with the potential of permanent destruction of the pilosebaceous unit and hair loss. Within the maze of varied conditions leading to scarring alopecia, the most important is to keep a neat nosologic classification in mind, based both on morphology and a pathogenic understanding. We believe that AANS represents a minor form of DCS, so far predominantly observed in patients of non-African origin, and therefore, is a disease of follicular occlusion with a favorable prognosis.

References

Branisteanu D, Molodoi A, Ciobanu D, Badescu A, Stoica L, Branisteanu D . The importance of histopathologic aspects in the diagnosis of dissecting cellulitis of the scalp. Rom J Morphol Embryol. 2009; 50(4):719-24. View

Malki L, Sarig O, Romano M, Mechin M, Peled A, Pavlovsky M . Variant in Central Centrifugal Cicatricial Alopecia. N Engl J Med. 2019; 380(9):833-841. DOI: 10.1056/NEJMoa1816614. View

Lee S, Kim S, Im M, Lee Y, Seo Y, Lee J . Pseudocyst of the scalp. Ann Dermatol. 2011; 23(Suppl 2):S267-9. PMC: 3229083. DOI: 10.5021/ad.2011.23.S2.S267. View

Abdennader S, Vignon-Pennamen M, Hatchuel J, Reygagne P . Alopecic and aseptic nodules of the scalp (pseudocyst of the scalp): a prospective clinicopathological study of 15 cases. Dermatology. 2010; 222(1):31-5. DOI: 10.1159/000321475. View

Fischer-Levancini C, Gompertz M, Guglielmetti A, Opazo H . Alopecic and Aseptic Nodules of the Scalp: First Report in South America and Second in America. Skin Appendage Disord. 2018; 4(2):78-81. PMC: 5939671. DOI: 10.1159/000479166. View

Semble A, McMichael A . Hair loss in patients with skin of color. Semin Cutan Med Surg. 2015; 34(2):81-8. DOI: 10.12788/j.sder.2015.0145. View

Seol J, Park I, Kim D, Park S, Kang J, Kim H . Alopecic and Aseptic Nodules of the Scalp/Pseudocyst of the Scalp: Clinicopathological and Therapeutic Analyses in 11 Korean Patients. Dermatology. 2015; 232(2):165-70. DOI: 10.1159/000441219. View

Bourezane Y, Bourezane H . [Two new trichoscopic signs in alopecic and aseptic nodules of the scalp: "Eastern pancake sign" and comedo-like structures]. Ann Dermatol Venereol. 2014; 141(12):750-5. DOI: 10.1016/j.annder.2014.09.010. View

Eisenberg E . Alopecia-associated pseudocyst of the scalp. J Am Acad Dermatol. 2012; 67(3):e114-6. DOI: 10.1016/j.jaad.2011.09.028. View

10.

Fischer-Levancini C, Iglesias-Sancho M, Collgros H, Sanchez-Regana M . Aseptic and alopecic nodules of the scalp. Actas Dermosifiliogr. 2013; 105(2):208-11. DOI: 10.1016/j.ad.2013.01.007. View

11.

Rodriguez-Lobato E, Morgado-Carrasco D, Giavedoni P, Ferrando J . Alopecic and aseptic nodule of the scalp in a girl. Pediatr Dermatol. 2017; 34(6):697-700. DOI: 10.1111/pde.13293. View

12.

Harries M, Trueb R, Tosti A, Messenger A, Chaudhry I, Whiting D . How not to get scar(r)ed: pointers to the correct diagnosis in patients with suspected primary cicatricial alopecia. Br J Dermatol. 2009; 160(3):482-501. DOI: 10.1111/j.1365-2133.2008.09008.x. View

13.

Bellinato F, Maurelli M, Colato C, Gisondi P, Girolomoni G . Alopecic and aseptic nodules of the scalp: A new case with a systematic review of the literature. Clin Case Rep. 2021; 9(6):e04153. PMC: 8222653. DOI: 10.1002/ccr3.4153. View

14.

Garrido-Colmenero C, Arias-Santiago S, Aneiros Fernandez J, Garcia-Lora E . Trichoscopy and ultrasonography features of aseptic and alopecic nodules of the scalp. J Eur Acad Dermatol Venereol. 2014; 30(3):507-9. DOI: 10.1111/jdv.12903. View

15.

Al-Hamdi K, Qais Saadoon A . Alopecic and Aseptic Nodules of the Scalp with a Chronic Relapsing Course. Int J Trichology. 2020; 11(6):244-246. PMC: 6984049. DOI: 10.4103/ijt.ijt_106_19. View

16.

Melo D, Slaibi E, Siqueira T, Tortelly V . Trichoscopy findings in dissecting cellulitis. An Bras Dermatol. 2019; 94(5):608-611. PMC: 6857556. DOI: 10.1016/j.abd.2019.09.006. View

17.

Abdennader S, Reygagne P . Alopecic and aseptic nodules of the scalp. Dermatology. 2008; 218(1):86. DOI: 10.1159/000165608. View

18.

Melo D, Trueb R, Dutra H, Lima M, Machado C, Gavazzoni Dias M . Low-dose isotretinoin as a therapeutic option for dissecting cellulitis. Dermatol Ther. 2020; 33(6):e14273. DOI: 10.1111/dth.14273. View

19.

Tsuruta D, Hayashi A, Kobayashi H, Nakagawa K, Furukawa M, Ishii M . Pseudocyst of the scalp. Dermatology. 2005; 210(4):333-5. DOI: 10.1159/000084761. View

20.

Sperling L, Solomon A, Whiting D . A new look at scarring alopecia. Arch Dermatol. 2000; 136(2):235-42. DOI: 10.1001/archderm.136.2.235. View