CASE REPORT   

Giornale Italiano di Dermatologia e Venereologia 1998 August;133(4):269-71

Copyright © 1998 EDIZIONI MINERVA MEDICA

language: Italian

Dissecting folliculitis of the scalp (Hoffmann’s disease). Report of a case

Mazzatenta C., Giorgino G., Rubegni P., De Aloe G., Fimiani M.

Università degli Studi - Siena, Istituto di Dermatologia e Venereologia

Perifolliculitis Capitis Abscedens et Suffodiens or Hoffman’s disease (PCAS) is a rare condition characterized by tender nodules and a dissecting cellulitis of the vertices. Patchy alopecia with scarring may also occur as a consequence of abscess formation. PCAS is most frequently observed in young blacks and is sometimes associated with nodular acne or hydrosadenitis suppurativa. The pathogenesis of the disease is not clear; most authors believe that it is triggered by occlusion of the follicular infundibulum as in nodular acne or hydradenitis suppurativa. This is why these three diseases are generally classified together as the so called “follicular occlusion triad”. PCAS is difficult to treat and often follows a relapsing course. Antibiotics, antimycotics and steroids are ineffective. Isotretinoin and zinc sulfate have been reported to be beneficial. A case of Hoffman’s disease in a young caucasian man successfully treated with 0.7 mg/kg/ day of isotretinoin for 6 months is reported. After a follow up period of more that 20 months the patients is still well.