Erosive pustular dermatosis of the scalp

• Published in: Dermatology online journal Vol. 26; no. 8
• Main Authors: Marsh, Rachel L, Spohn, Gina P, Kaffenberger, Jessica A
• Format: Journal Article
• Language: English
• Published: United States University of California Digital Library - eScholarship 01-01-2020
• Subjects: Alopecia; Alopecia - etiology; Alopecia - pathology; Alopecia - prevention & control; Anti-Inflammatory Agents - therapeutic use; Baldness; Female; Humans; Meningeal Neoplasms - radiotherapy; Meningeal Neoplasms - surgery; Meningioma - radiotherapy; Meningioma - surgery; Middle Aged; Mometasone Furoate - therapeutic use; Osteomyelitis - etiology; Prednisone - therapeutic use; Radiosurgery - adverse effects; Scalp - pathology; Scalp Dermatoses - diagnosis; Scalp Dermatoses - drug therapy; Scalp Dermatoses - pathology; Skin diseases; Skin Diseases, Vesiculobullous - diagnosis; Skin Diseases, Vesiculobullous - drug therapy; Skin Diseases, Vesiculobullous - pathology
• ISSN: 1087-2108; 1087-2108
• DOI: 10.5070/D3268049900

Erosive pustular dermatosis of the scalp (EPDS) is a rare inflammatory condition commonly associated with antecedent iatrogenic insult. EPDS may be diagnostically challenging owing to a lack of pathognomonic histologic findings and cutaneous manifestations that overlap with alternative dermatologic conditions. Therefore, EPDS may be more common than previously recognized. We present a 60-year-old woman with a four-year history of non-healing scalp erosions, progressive skin atrophy, and scarring alopecia despite intravenous antibiotics and intraoperative debridement who improved with systemic glucocorticoids. Our report emphasizes the importance of early recognition of EPDS when delayed wound healing and erosive disease occur in the setting of iatrogenic injury to the scalp. Timely treatment with systemic anti-inflammatory agents is paramount to prevent cicatricial alopecia and mitigate further scalp insult in EPDS.