Diagnostic value of trichoscopic findings of hair and scalp in dissecting cellulitis: case report and review of the literature

Dissecting cellulitis of the scalp (DCS) is an infrequent, chronic inflammatory scalp condition that predominantly affects hair follicles and results in scarring alopecia if untreated. The pathogenesis remains poorly documented and challenging to diagnose. This case highlights the value of trichoscopy as a non-invasive imaging technique in the diagnosis of DCS. We report the case of a 28-year-old female with a one-year history of worsening scalp lesions and hair loss. Examination revealed hairless nodules of the scalp, associated with exudation and pigmentation. Trichoscopy revealed significant findings, including yellow dots, broken hairs, black dots, and features associated with primary scarring alopecia, such as white dots, tufted hairs, and perifollicular pustules. Trichoscopy demonstrates significant potential for early diagnosis and intervention, aiding in the prevention of disease progression and reducing the need for invasive procedures such as biopsies. It allows for the detection of characteristic patterns, facilitating differentiation from other types of alopecia. This case shows the importance of this non-invasive tool for the early diagnosis and treatment of DCS.