Dissecting cellulitis treated with the long-pulsed Nd:YAG laser.

Background: Dissecting cellulitis is a chronic inflammatory scalp condition characterized by pustular nodules, sinus tract formation, and resultant cicatricial alopecia. Current treatments are of limited efficacy.

Objective: This report explored treating dissecting cellulitis with the long-pulsed Nd:YAG laser to determine the capabilities and limitations of this modality with respect to: (1) reducing pus formation; (2) enabling the termination of systemic treatments; (3) investigating the side-effect profile including dyspigmentation and scarring alopecia; and (4) terminating the disease process.

Methods: This observational study followed four patients with long-standing dissecting cellulitis through consecutive treatments with the long-pulsed Nd:YAG laser without epidermal cooling.

Results: One year after initiating laser treatment, patients achieved decreased pus formation, a reduced reliance on systemic treatments, and a controlled or terminated disease process without dyspigmentation. Three patients had regrowth of terminal hairs in treatment sites.

Conclusion: The long-pulsed Nd:YAG laser is effective in attenuating the progression of dissecting cellulitis without appreciable adverse cutaneous side effects. This is a pilot study, and more patients must be treated in other trials to verify these findings.