Erosive pustular dermatosis of the scalp induced by ingenol mebutate

Rongioletti, Franco; Chinazzo, Chiara; Javor, Sanja

doi:10.1111/jdv.13350

Cited by 22 publications

(20 citation statements)

References 6 publications

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“…Reported triggers include laser treatment, radiation therapy, photodynamic therapy, cryotherapy, surgery and hair transplants . Topical therapies such as minoxidil, latanoprost, tretinoin, ingenol mebutate, 5‐fluorouracil and imiquimod have also been associated with EPDS . Pre‐existing aplasia cutis congenita, burns, contact dermatitis and herpes zoster have also been reported to precede EPDS .…”

Section: Aetiologymentioning

confidence: 99%

Erosive pustular dermatosis of the scalp – an Australian perspective: Insights to aid clinical practice

2019

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Erosive pustular dermatosis of the scalp has particular relevance in Australia, due to its association with actinic damage. Despite its rarity, the recalcitrant nature of erosive pustular dermatosis of the scalp dictates a protracted recovery fraught with relapse and recurrence, posing inherent challenges to successful treatment and complete recovery. In Australia, erosive pustular dermatosis of the scalp is prevalent in the elderly, who are negatively affected due to the condition. We propose a management outline to aid clinical practice, to improve the quality of life in the elderly, whilst providing insight into the current understanding and treatment of erosive pustular dermatosis of the scalp.

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Section: Aetiologymentioning

confidence: 99%

Erosive pustular dermatosis of the scalp – an Australian perspective: Insights to aid clinical practice

2019

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“…That the driving force of the disease is the exaggerated immune response is evidenced by a recent report of concomitant elevation of serum matrix metalloproteinase-3 in patients with EPD [34] and multiple cases that have been successfully treated with immunosuppressive therapies [2,35,36,37]. Amplification of the immune reaction can also be triggered by topical treatments used in dermatology including imiquimod, 5-fluorouracil, and ingenol mebutate, which have been reported to cause EPD in chronically sun-damaged patients [8,38,39]. …”

Section: Discussionmentioning

confidence: 93%

“…When eventual healing does occur, there is typically residual scarring alopecia in affected areas of the scalp, or scarring with post-inflammatory hyperpigmentation on the legs [1,5]. Triggering factors include various forms of damage to cutaneous integrity including physical and topical therapy, surgery, malignancy, and trauma [5,6,7,8,9,10,11]. Acute pustulosis of the scalp is a newer variant of the disease that has been recently described [12].…”

Section: Introductionmentioning

confidence: 99%

Erosive Pustular Dermatosis: A Manifestation of Immunosenescence A Report of 8 Cases

Thuraisingam

Mirmirani

2017

Skin Appendage Disord

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Erosive pustular dermatosis (EPD) is a rare condition of the scalp and legs that is marked by crusted erosions or superficial ulcerations that may result in scarring alopecia and chronic wounds. The condition predominantly affects elderly female as compared to male patients. Its pathogenesis remains poorly understood. The majority of the cases in the literature are from the United Kingdom and continental Europe. In this series, we present 8 North American patients with EPD of the scalp, one of whom also had involvement of the legs and another with the involvement of the face. All our patients were advanced in age and had a predisposition to chronic actinic damage, which are common characteristics of EPD previously reported in the literature. We hypothesize that immunosenescence leads to an aberrant immune response to wound healing and, along with other factors such as a loss of the normal epidermal barrier, ultraviolet damage, and hormonal factors, may contribute to the development of this condition.

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“…The hyperkeratotic lesions are not painful and pruritus is rare [3]. Triggers have been reported to include imiquimod [4], ingenol mebutate [5], and herpes zoster [6]. Corticosteroids have been proven to be effective in the treatment of most of these cases.…”

Section: Answermentioning

confidence: 99%