Hair disorders: dissecting cellulitis of the scalp: practice question

A Dermatology question in the style of the NEET PG paper. Answer it first, then read why the right option is right and why each of the others is wrong.

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Dermatology · Hair disorders: dissecting cellulitis of the scalp

Sample item

A young man has painful, boggy, interconnected nodules with sinus tracts discharging pus on the scalp and scarring alopecia. Which drug is most useful in recalcitrant disease?

Original practice item, not a recalled exam question. Nothing here is recorded.

The answer and the reasoning

B. Oral isotretinoin

Dissecting cellulitis (perifolliculitis capitis abscedens et suffodiens) is part of the follicular occlusion tetrad with hidradenitis suppurativa, acne conglobata and pilonidal sinus. Oral isotretinoin is the most effective for recalcitrant disease, and biologics are considered for resistant cases. Cultures are usually sterile or show secondary infection.

Option by option

  • A. Topical minoxidil

    Minoxidil does not treat inflammation.

  • B. Oral isotretinoin (correct)

    Correct. Isotretinoin is effective in dissecting cellulitis.

  • C. Oral ivermectin

    Ivermectin does not treat this condition.

  • D. Oral terbinafine

    Terbinafine treats fungal infection.

Source note: Original NextPrep sample item — pending expert review. This item is original practice material awaiting independent expert review, so confirm important facts in a standard textbook.

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Questions about this Dermatology question

What is the answer to this Dermatology question?

The best answer is B, Oral isotretinoin. Dissecting cellulitis (perifolliculitis capitis abscedens et suffodiens) is part of the follicular occlusion tetrad with hidradenitis suppurativa, acne conglobata and pilonidal sinus.

Why is "Topical minoxidil" not the answer?

Minoxidil does not treat inflammation.

Why is "Oral ivermectin" not the answer?

Ivermectin does not treat this condition.

Why is "Oral terbinafine" not the answer?

Terbinafine treats fungal infection.

What concept does this question test?

It tests Hair disorders: dissecting cellulitis of the scalp in Dermatology. Oral isotretinoin is the most effective for recalcitrant disease, and biologics are considered for resistant cases. Cultures are usually sterile or show secondary infection.

How hard is this question?

We tag it as an application question: it asks you to use a fact on a patient or a finding. The tag is our own editorial judgement, not an official difficulty rating, so read the reason for every option, not only the answer.

How should I study Hair disorders: dissecting cellulitis of the scalp?

Learn each condition by its primary lesion, site and signature sign. Then use the flashcards and the other Dermatology questions on this site to test what stuck.

Is this a real NEET PG question?

No. It is an original practice item (editorial status: sample, version 1). NextPrep does not publish recalled or leaked questions, and independent faculty review of this item has not been completed yet, so confirm important facts in a standard textbook.