title: Erosive pustular dermatosis of the scalp: a case report and review of the literature.
abstract: 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.
authors.affiliation: Dermatologic Institute S. Gallicano, IRCCS, Rome, Italy.
authors.forename: A
authors.initials: A
authors.lastname: Mastroianni
authors.forename: C
authors.initials: C
authors.lastname: Cota
authors.forename: M
authors.initials: M
authors.lastname: Ardigò
authors.forename: E
authors.initials: E
authors.lastname: Minutilli
authors.forename: E
authors.initials: E
authors.lastname: Berardesca
mesh_terms: D000287:Administration, Topical; D000900:Anti-Bacterial Agents / Q000008:administration & dosage; D003879:Dermatologic Agents / Q000627:therapeutic use; D006801:Humans; D015474:Isotretinoin / Q000627:therapeutic use; D008297:Male; D008875:Middle Aged; D012536:Scalp Dermatoses / Q000150:complications / Q000175:diagnosis* / Q000628:therapy; D017592:Skin Care / Q000379:methods; D012872:Skin Diseases, Vesiculobullous / Q000150:complications / Q000175:diagnosis* / Q000628:therapy; D016896:Treatment Outcome
chemical_list: D000900:Anti-Bacterial Agents; D003879:Dermatologic Agents; D015474:Isotretinoin