Dissecting Cellulitis in Children and Adolescents: A Comprehensive Review.

Abstract

Background: Dissecting cellulitis is a chronic primary scarring alopecia characterized by pustules, nodules, abscesses, and sinus tracts that progress to permanent hair loss. Its prevalence is low, and reports in pediatric populations are scarce.

Summary: This review aims to expand current understanding of dissecting cellulitis in pediatric population, highlighting it as a potential differential diagnosis at this age group to enable early diagnosis and prevent complications. A literature review was conducted using PubMed, Google Scholar, and SciELO, employing English and Spanish terms: "dissecting cellulitis," "children," "pediatrics," and "perifolliculitis capitis abscedens et suffodiens," covering publications from 1999 to 2025. Dissecting cellulitis is an uncommon disease in pediatric patients. Its pathogenesis is multifactorial, and it is clinically characterized by papules and pustules that evolve into nodules, abscesses, and fistulous tracts, leading to disfiguring scars and alopecia. Diagnosis is primarily clinical, supported by trichoscopy and histopathological examination. Differential diagnosis with other conditions is crucial to prevent its irreversible course. Although no standardized treatment protocol exists, multiple therapeutic options have been successfully employed in pediatric cases.

Key messages: Recognizing that dissecting cellulitis can occur in pediatric patients is essential to achieve early diagnosis and treatment, thereby preventing irreversible sequelae with significant psychosocial impact.