The importance of histopathologic aspects in the diagnosis of dissecting XXXX .

@entity1665 @entity1 @entity4878 @entity66 @entity738 @entity5656 @entity75 @entity14663 @entity4580 @entity2177 @entity10211 @entity25911 @entity3100 @entity1613 @entity432 @entity803 @entity6691 @entity11885
@entity25911 or dissecting @entity14663 also known as "perifoliculitis @entity3100 abscedens et suffodiens" (PCAS), is a rare, severe and distinct @entity66 . It most probably occurs because of @entity432 via @entity5656 , having the same mechanism of acnea conglobata and @entity6691 suppurativa. These dermatoses may be associated or may have an isolated evolution. PCAS is one of the primitive cicatricial @entity1665 of neutrophilic type (with pustules). What is characteristic for the histopathologic picture of the disease is the deep inflammatory infiltrate, placed at the reticular derm or hypoderm level. The @entity1613 evolves towards forming profound abscesses and the destruction of polysebaceous follicles because of @entity738 , usually lymphoplasmocitary and with gigantic cells. Here is the case of a 24-year-old male with records of acne conglobata and @entity11885 , with relapsed inflammatory nodular lesions on the surface of the alopecic plaques and follicular pustules on their margin. The @entity1 had followed before hospitalizing a systemic treatment with antibiotics ( @entity4580 , @entity803 , @entity2177 , in therapeutic schemes that the @entity1 cannot mention, but anyway of short time) and after that a treatment with @entity4878 ( @entity10211 , 20-30 mg/day, in two successive therapies of one month each). The evolution of the disease under these treatments was with outbreaks and short times of remission of the @entity75 and nodular lesions of the scalp. The clinical diagnosis of PCAS is difficult, especially in the initial stage of the disease, as it was the case of the @entity1 presented here. We underline the importance of a correct history of the disease, of the complete clinical exams and the need of paraclinical investigations (histopathologic exam from the lesional biopsy - microscopy and immunohistochemistry) in order to come with a positive diagnosis of PCAS and a differential one.
