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Dissecting cellulitis (DC) of the scalp is a chronic, clinically refractory inflammatory skin disorder. Herein is a presentation of a male with refractory DC with concurrent hidradenitis suppurativa, who had failed treatment with multiple topical and systemic therapies. After receiving guselkumab, 100 mg subcutaneously every 8 weeks, the patient exhibited marked improvement, with normalization of symptoms and signs.