Erosive Pustular Dermatosis of the Scalp: A Case Report and Review of the LiteratureMastroianni A. · Cota C. · Ardigò M. · Minutilli E. · Berardesca E.
Dermatologic Institute S. Gallicano, IRCCS, Rome, Italy
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Article / Publication Details
Erosive pustular dermatosis of the scalp (EPDS) is a rare entity characterized by pustular, erosive and crusted lesions of the scalp with progressive scarring alopecia. The aetiology is unknown, but predisposing factors have been reported such as trauma, skin grafting, prolonged exposure to UV light of a bald scalp as well as co-existence of auto-immune diseases. Laboratory data, bacteriological and mycological investigations and histopathology are generally not diagnostic. A 45-year-old Caucasian man with 1-year-old pustular, erosive and crusted lesions on his bald scalp was seen. Laboratory data, including auto-immunity, bacteriological and mycological investigations were negative. Histopathology was not diagnostic showing a diffuse polymorphous infiltrate involving the dermis. A diagnosis of EPDS was made. The patient was treated with topical and systemic antibiotics and steroids as well as oral nimesulide with no or partial response. Consequently, isotretinoin (0.75 mg/kg/day) was started obtaining complete resolution in few months. No relapse after 1 year of follow-up was seen. EPDS represents a distinct disease with a history of relapsing and unsatisfactory response to common treatments. Systemic retinoids may be considered as a potentially resolutive choice.
© 2005 S. Karger AG, Basel
- Burton JL: Case for diagnosis: Pustular dermatosis of scalp. Br J Dermatol 1977;97(suppl 15):67.
- Pye RJ, Peachey RDG, Burton JL: Erosive pustular dermatosis of the scalp. Br J Dermatol 1979;100:559–566.
- Neild VS: Erosive pustular dermatosis of the scalp. Clin Exp Dermatol 1981;6:677–679.
- Bieber T, Ruzicka T, Burg G: Erosive pustulous dermatitis of the scalp. Hautarzt 1987;38:687–689.
- Burton JL, Peachey RDG, Pye RJ: Erosive pustular dermatosis of the scalp – A definition. Br J Dermatol 1988;119:411.
- Parodi A, Ciaccio M, Rebora A: Erosive pustular dermatosis of the scalp. Int J Dermatol 1990;29:517–518.
Moisson YF, Janier M, Le Bozec P, et al: Erosive pustular dermatitis of the scalp. Ann Dermatol Vénéréol 1991;118:899–901.
- Caputo R, Veraldi S: Erosive pustular dermatosis of the scalp. J Am Acad Dermatol 1993;28:96–98.
Loche F, Bayle-Lebey P, Marguery MC, et al: A case for diagnosis: Erosive pustular dermatosis of the scalp. Ann Dermatol Vénéréol 1995;122:799–800.
- Ena P, Lissa M, Doneddu GM, Lampus GV: Erosive pustular dermatosis of the scalp in skin grafts: Report of three cases. Dermatology 1997;194:80–84.
- Rongioletti F, Delmonte S, Rossi ME, Strani GF, Rebora A: Erosive pustular dermatosis of the scalp following cryotherapy and topical tretinoin for actinic keratosis. Clin Exp Dermatol 1999;24:499–500.
- Grattan CE, Peachey RD, Boon A: Evidence for a role of local trauma in the pathogenesis of erosive pustular dermatosis of the scalp. Clin Exp Dermatol 1988;13:7–10.
- Watanabe S, Takizawa K, Hashimoto N, Ishibashi Y: Pustular dermatosis of the scalp associated with autoimmune diseases. J Dermatol 1989;16:383–387.
- Yamamoto T, Furuse Y: Erosive pustular dermatosis of the scalp in association with rheumatoid arthritis. Int J Dermatol 1995;34:148.
Bonerandi JJ: Erosive and pustular scalp diseases. Ann Dermatol Vénéréol 1999;126:311–312.
Noe C, Grob JJ, Choux R, Bonerandi JJ: Erosive pustulosis of the scalp: A spongiform pustular dermatosis? Ann Dermatol Vénéréol 1993;120:693–695.
- Yang CC, Hsu MM, Chen W: Folliculitis decalvans associated with micronychia. Dermatology 2004;208:227–228.
- Powell JJ, Dawber RP, Gatter K: Folliculitis decalvans including tufted folliculitis: Clinical, histological and therapeutic findings. Br J Dermatol 1999;140:328–333.
- Stites PC, Boyd AS: Dissecting cellulitis in a white male: A case report and review of the literature. Cutis 2001;67:37–40.
- Scerri L, Williams HC, Allen BR: Dissecting cellulitis of the scalp: Response to isotretinoin. Br J Dermatol 1996;134:1105–1108.
- Jacyk WK: Pustular ulcerative dermatosis of the scalp. Br J Dermatol 1988;118:441–444.
- Ikeda M, Arata J, Isaka H: Erosive pustular dermatosis of the scalp successfully treated with oral zinc sulphate. Br J Dermatol 1982;106:742–743.
- Bahmer FA: Erosive pustular dermatosis of the scalp: A new entity or a variant of pyoderma vegetans. Z Hautkr 1985;60:517–526.
- Abeck D, Korting HC, Braun-Falco O: Folliculitis decalvans: Long-lasting response to combined therapy with fusidic acid and zinc. Acta Derm Venereol 1992;72:143–145.
- Kobayashi H, Aiba S, Tagami H: Successful treatment of dissecting cellulitis and acne conglobata with oral zinc. Br J Dermatol 1999;141:1137–1138.
- Laffitte E, Kaya G, Piguet V, Saurat JH: Erosive pustular dermatosis of the scalp: Treatment with topical tacrolimus. Arch Dermatol 2003;139:712–714.
- Boffa MJ: Erosive pustular dermatosis of the scalp successfully treated with calcipotriol cream. Br J Dermatol 2003;148:593–595.
- Lovell CR, Harman RRM, Bradfield JWB: Cutaneous carcinoma arising in erosive pustular dermatosis of the scalp. Br J Dermatol 1980;102:325–328.
- Trueb RM: Is androgenetic alopecia a photoaggravated dermatosis? Dermatology 2003;207:343–348.
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