title: Modern external beam radiation therapy for refractory dissecting cellulitis of the scalp.
abstract: BACKGROUND
  Dissecting cellulitis of the scalp can be an extremely painful and disfiguring dermatological condition. The associated pain can be severe enough in some cases to require opioid analgesics, and this pain in conjunction with the disfigurement can induce significant emotional distress. Conservative treatments often fail to provide relief. Radiation therapy has been successfully used in the past but with outdated equipment and techniques.
  
  
  OBJECTIVE
  To evaluate the efficacy and toxicity of modern external beam radiation therapy techniques for the treatment of dissecting cellulitis of the scalp.
  
  
  METHODS
  Four patients with intractable dissecting cellulitis of the scalp were treated with electrons or a combination of electrons and photons to the entire scalp. Daily fraction sizes were 2.5 or 3 Gy and initially prescribed to 15-21 Gy. Patients were re-evaluated 3-4 weeks after completion of therapy. Any residual hair growth was treated with additional radiation treatments to ensure full epilation, up to a maximum dose of 35 Gy.
  
  
  RESULTS
  Rapid resolution of pain was seen in all patients with pain. Regression of nodules and decreased discharge was seen in all patients following treatment and cosmesis was subjectively improved. No long-term toxicity has been observed.
  
  
  CONCLUSIONS
  Using modern techniques and equipment, radiation therapy appears to be a reasonable option for patients with severe/refractory dissecting cellulitis of the scalp. Acute effects are mild and well tolerated. Aside from alopecia, which was present to some extent in all patients before treatment, no long-term complications have been observed.
authors.affiliation: Department of Human Oncology, University of Wisconsin Medical School, Madison, WI 53792, USA.
authors.forename: P
authors.initials: P
authors.lastname: Chinnaiyan
authors.forename: L B
authors.initials: LB
authors.lastname: Tena
authors.forename: M J
authors.initials: MJ
authors.lastname: Brenner
authors.forename: J S
authors.initials: JS
authors.lastname: Welsh
mesh_terms: D000328:Adult; D002481:Cellulitis / Q000150:complications / Q000532:radiotherapy*; D006801:Humans; D008297:Male; D010146:Pain / Q000209:etiology / Q000532:radiotherapy; D011878:Radiotherapy / Q000009:adverse effects; D012536:Scalp Dermatoses / Q000150:complications / Q000532:radiotherapy*; D016896:Treatment Outcome