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Introduction: Dissecting cellulitis of the scalp, or Hoffman disease, is described as an extremely rare condition. Clinically, it is represented by recurrent painful nodules, purulent drainage, interconnected sinus tracts and keloid formation, leading to scaring and cicatricial alopecia. Without a precise diagnosis and an adequate treatment, the repercussions consist of severe infectious complications along with psychological negative effects and serious aesthetic alterations. There is no standard treatment. In refractory cases, surgical management is reported. Patient concerns: We report a case of a 65-year-old Caucasian male patient, with a 5-year history of Hoffman disease, who presented with multiple abscesses and sinus tracts of the scalp and patches of alopecia. The lesions were non-responsive to medical treatment. Diagnosis: The diagnosis of DCS has been established on the basis of the clinical appearance and has been confirmed histopathologically. Interventions: The patient underwent wide excision of the scalp, followed by reconstruction using free latissimus dorsi flap and covered by meshed split-thickness skin graft. Outcomes: Eighteen-month follow-up revealed complete remission of symptoms and lesions along with satisfactory cosmetic result. Conclusion: The scope of this case report is to raise awareness of the following aspects: Hoffman disease has an extremely low occurrence rate, a difficult differential diagnosis and no standard therapeutical strategy. It also highlights the effectiveness of scalpectomy and free latissimus dorsi flap covered by meshed split-thickness skin graft in treating a very advanced stage of the disease together with providing a natural contouring of the scalp. Ultimately, it discusses the other treatment alternatives.

Prurigo (PP) and pruritic folliculitis of pregnancy (PFP) are poorly characterized entities. Traditionally classified under specific dermatoses of pregnancy, they were reclassified under a new umbrella entity, atopic eruption of pregnancy (AEP), which also includes atopic dermatitis (AD) that can worsen or present for the first time in pregnancy. Still, several aspects of AEP have not been adequately elucidated. It needs to be clarified whether it is the intrinsic ("nonallergic" or "atopiform dermatitis") or extrinsic (immunoglobulin E-associated) AD that is affected by pregnancy. Future studies need to examine the postpartum prognosis of AD that develops for the first time during gestation. A revision of diagnostic criteria of AEP will allow a more accurate estimate of its prevalence, as well as clarification of the relationship between AD and specific dermatoses, such as PP and PFP. In this context, this review discusses the history, epidemiologic data, clinicopathologic features, and management of these entities.

Microangiolopatic ulcerations represent a peculiar kind of ulceration. Though not rare, there is still not enough known about them and treatment is inadequate, usually long term and deceiving. We have followed 66 patients with microangiolopathic ulcerations secondary to metabolic disorders (diabetes mellitus), vascular disorders (vascularitis, atherosclerosis, high blood pressure, arteritis, postthrombotic syndrome, atrophie blanche), postcombustive syndrome, scleroderma, lupus eritematosus, and other disorders. Besides the clinical investigation, the patients have been investigated by biochemistry tests, rheography, photopletismoraphy, Doppler ultrasonography, detailed examination of ocular fundi, morphopathological examination of the ulcerated and apparently healthy skin, soft tissue radiography, phlebography, arteriography, or lymphography. A therapeutic attempt in a group of six patients, consisting of sublesional infiltrations and/or ulcus scarification according to the patient's personal biorithms, had encouraging results.

The main circulatory function of the lymphatic system consists in bringing macro-molecules back into the blood circulation from the interstitial space of the sustaining lax connective tissue.