School of Medicine, University of Texas Southwestern Medical Center, Dallas, TX, USA.
Department of Dermatology, Johns Hopkins School of Medicine, Baltimore, MD, USA.
J Dermatolog Treat. 2021 Mar;32(2):144-149. doi: 10.1080/09546634.2019.1642441. Epub 2019 Aug 9.
Dissecting cellulitis is a chronic inflammatory dermatosis that results in disfiguring and painful, purulent lesions. Treatment of patients with disease resistant to standard therapies, including intralesional or topical steroids or antibiotics, can be a dilemma for clinicians.
We performed a systematic review of the literature in November 2018 to find articles which presented treatment options and outcomes of patients who failed prior treatment with standard therapies.
We identified 57 articles of interest, with 53 being case studies or series. Isotretinoin was the most often reported, but the response was limited. Biologics and laser therapy were used less often but demonstrated a better chance of remission. X-ray epilation and surgical excision demonstrated the best remission rates but can be complicated by serious morbidity.
We propose a regimen for the treatment of recalcitrant cases of dissecting cellulitis. In the future, more robust studies including randomized control trials are needed to identify the preferred treatment options for refractory dissecting cellulitis.
解剖性蜂窝织炎是一种慢性炎症性皮肤病，可导致毁容和疼痛、化脓性病变。对于那些对抗生素或皮质类固醇标准疗法有抗药性的患者，治疗可能是临床医生的难题。
我们于 2018 年 11 月进行了文献系统回顾，以寻找先前接受标准疗法治疗失败的患者的治疗选择和结果的文章。
我们确定了 57 篇有兴趣的文章，其中 53 篇是病例研究或系列报告。异维 A 酸是最常报告的，但反应有限。生物制剂和激光治疗的使用较少，但显示出更好的缓解机会。X 射线脱毛和手术切除显示出最好的缓解率，但可能会导致严重的发病率。
我们提出了一种治疗复发性解剖性蜂窝织炎的方案。将来，需要更有力的研究，包括随机对照试验，以确定治疗难治性解剖性蜂窝织炎的首选治疗方案。
