Hoffman's Dissecting Folliculitis: Principles of Diagnosis and Treatment - A Literature Review

Dissecting cellulitis of the scalp is a rare chronic inflammatory condition characterized by abscesses, sinus tracts, and scarring alopecia. A review of literature from 2015 to 2025 highlights that follicular occlusion and cytokine-mediated inflammation (TNF-α, IL-17) are central to its pathogenesis. Systemic isotretinoin is highly effective, with up to 90% efficacy, while antibiotics offer only temporary relief. Biologic agents and JAK inhibitors show promise for resistant cases, and procedural or surgical methods are reserved for severe stages. The trend in treatment is moving towards pathogenetically targeted therapies, but controlled studies are needed to establish clinical guidelines.