title: Erosive pustular dermatosis of the scalp: Clinical, trichoscopic, and histopathologic features of 20 cases.
abstract: BACKGROUND
  Erosive pustular dermatosis of the scalp is a chronic eruption that leads to scarring alopecia.
  
  
  OBJECTIVE
  The clinical, dermoscopic, and histopathological features and the course of the disease in 20 patients were reviewed and compared with the reports in the literature.
  
  
  METHODS
  Gender, age at diagnosis, age at onset, duration, topography, predisposing factors, concomitant diseases, trichoscopy, histology, treatment, and outcome were taken into consideration.
  
  
  RESULTS
  The mean age was 59.4 years. Androgenetic alopecia was present in 12 patients, 6 of whom showed actinic damage. Trauma was reported in 9 patients. Four patients were affected by autoimmune disorders. The vertex was the most common location. In all 20 patients trichoscopy showed an absence of follicular ostia with skin atrophy. Histopathology revealed 3 different features, depending on the disease duration. A reduction of inflammatory signs was observed in 14 patients treated with topical steroids and in all 3 patients treated with topical tacrolimus 0.1%.
  
  
  CONCLUSIONS
  The rarity of this disease is a limitation.
  
  
  CONCLUSIONS
  The relatively high number of patients allowed us to identify a better diagnostic approach, using trichoscopy, and a more effective therapeutic strategy, with high-potency steroids or tacrolimus, which should be considered as first-line treatment.
authors.affiliation: Department of Specialized, Clinical, and Experimental Medicine, Division of Dermatology, University of Bologna, Bologna, Italy.
authors.forename: Michela
authors.initials: M
authors.lastname: Starace
authors.affiliation: Department of Specialized, Clinical, and Experimental Medicine, Division of Dermatology, University of Bologna, Bologna, Italy. Electronic address: camilla.loi30@gmail.com.
authors.forename: Camilla
authors.initials: C
authors.lastname: Loi
authors.affiliation: Department of Specialized, Clinical, and Experimental Medicine, Division of Dermatology, University of Bologna, Bologna, Italy.
authors.forename: Francesca
authors.initials: F
authors.lastname: Bruni
authors.affiliation: Department of Specialized, Clinical, and Experimental Medicine, Division of Dermatology, University of Bologna, Bologna, Italy.
authors.forename: Aurora
authors.initials: A
authors.lastname: Alessandrini
authors.affiliation: Department of Specialized, Clinical, and Experimental Medicine, Division of Dermatology, University of Bologna, Bologna, Italy.
authors.forename: Cosimo
authors.initials: C
authors.lastname: Misciali
authors.affiliation: Department of Specialized, Clinical, and Experimental Medicine, Division of Dermatology, University of Bologna, Bologna, Italy.
authors.forename: Annalisa
authors.initials: A
authors.lastname: Patrizi
authors.affiliation: Department of Specialized, Clinical, and Experimental Medicine, Division of Dermatology, University of Bologna, Bologna, Italy.
authors.forename: Bianca Maria
authors.initials: BM
authors.lastname: Piraccini
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D046169:Dermoscopy; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D012536:Scalp Dermatoses / Q000188:drug therapy / Q000473:pathology*; D012872:Skin Diseases, Vesiculobullous / Q000188:drug therapy / Q000473:pathology*
keywords: cicatricial alopecia; erosive pustular dermatosis; histology; scalp; trauma; trichoscopy