Erosive pustular dermatosis of the leg associated with compression bandaging and fungal infection

Abstract

EPDL is a fairly common clinical picture seen in patients undergoing continuous compression bandaging. It may be produced by opportunistic, particularly fungal, infection. In almost half an infective aetiology cannot be demonstrated and a pyoderma gangrenosum-like process may be implicated.

Chronic atrophic erosive dermatosis of the scalp and extremities: A recharacterization of erosive pustular dermatosis

“…This has suggested to some that EPD should be classified as part of the neutrophilic dermatoses, probably as a subset of pyoderma gangrenosum. 24,25 However, we note that neutrophils, although usually present, do not predominate in the same way they do for pyoderma gangrenosum, Sweet's disease, and other conditions classified as the neutrophilic dermatoses.…”

“…When what appears to be EPD occurs on the legs, there is a reasonable possibility of dermatophyte infection, Majocchi's granuloma. 24 However, we conclude that, in most instances, organisms are present as colonizers rather than as a cause of the disease.…”

“…Since then, 17 additional cases occurring on the legs have been reported. [22][23][24][25] EPD is generally stated to be encountered only rarely and, in fact, no US patients have been described. However, one of the authors (P. J. L.) suspected that the disorder was actually quite common in the United States and that the correct diagnosis was simply overlooked.…”

Update on primary cicatricial alopecias

“…375 Reports of a variant of erosive pustular dermatosis affecting the leg 388 have been attributed to other diseases by some. 389 Differential diagnosis. The differential diagnosis is extensive and includes amicrobial pustulosis associated with autoimmune disease, pustular ulcerative dermatosis of the scalp, pyoderma gangrenosum, pustular psoriasis, kerion, bacterial folliculitis, cicatricial pemphigoid, pemphigus vulgaris, blastomycosis-like pyoderma, erosive candidiasis of the scalp, and temporal arteritis, among other possibilities.…”

Erosive pustular dermatosis of the leg: Long-term control with topical tacrolimus

“…[1][2][3][4][5][6][7][8] The clinical features of EPDL closely resemble that of erosive pustular dermatosis of the scalp (EPDS), which is characterized by pustular lesions that progressively merge into erosive and crusted areas on the scalp. 8 The histologies of both conditions are also very similar.…”