Erosive pustular dermatosis of the scalp: Therapy is the diagnosis

Meo, Nicola di; Corneli, Paola; Retrosi, Chiara; Conforti, Claudio; Fagotti, Serena; Longone, Michela; Vezzoni, Roberta; Bussani, Rossana; Zalaudek, Iris

doi:10.1111/dth.13128

Cited by 3 publications

(5 citation statements)

References 6 publications

(4 reference statements)

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“…A total of 25 studies [2,[6][7][8]12,15,16,25,49,[56][57][58][59][60][61][62][63][64][65][66][67][68][69][70] with 162 participants (112 males, 50 females) met the selection criteria (Table 2).…”

Section: Resultsmentioning

confidence: 99%

Erosive Pustular Dermatosis: Delving into Etiopathogenesis and Management

Bhargava

Yumeen

Henebeng

et al. 2022

Life

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Erosive pustular dermatosis (EPD) is a chronic inflammatory skin disorder that usually affects mature individuals. It predominantly affects the scalp and can lead to scarring alopecia. Risk factors include actinic damage and androgenetic alopecia. A traumatic insult to the skin is considered a vital trigger of the condition. EPD is a diagnosis of exclusion; thus, several neoplastic, infectious, vesiculobullous, and inflammatory conditions should be ruled out. Biopsy and clinicopathologic correlation are required to differentiate between EPD and these entities. A dysregulated, chronic immune response is considered central to the etiopathogenesis of EPD. We performed an evidence-based systematic review of the management options. There were predominantly studies with level IV and V evidence and only two with level III. Despite the responsiveness of EPD to potent topical steroids, such as clobetasol propionate, recurrence occurs after treatment withdrawal. With the available data, tacrolimus 0.1%, curettage-assisted aminolevulinic acid-photodynamic therapy, and systemic retinoids can be considered second-line options for EPD with a role in maintenance regimens. However, controlled data and more powerful studies are needed to make solid recommendations.

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Section: Resultsmentioning

confidence: 99%

Erosive Pustular Dermatosis: Delving into Etiopathogenesis and Management

Bhargava

Yumeen

Henebeng

et al. 2022

Life

View full text Add to dashboard Cite

show abstract

“…Although several therapeutic strategies have been proposed (topical tacrolimus, dapsone gel, and photodynamic therapy), none of these treatments have proven to be really effective, with the exception of high-potency topical corticosteroids, which guarantee a complete wound healing in almost 80% of patients. 2,3 However, EPDS typically shows a chronic progression and tends to relapse after steroid therapy is stopped. Moreover, skin atrophy associated with prolonged steroid use can perpetuate the disease by inducing new areas of pustules and erosions at the periphery of affected skin.…”

Section: Topical Zinc Oxide: Breaking the Vicious Cycle Of Erosive Pu...mentioning

confidence: 99%

“…Due to the absence of peculiar features, diagnosis of EPDS is of exclusion and requires a high suspicion in the appropriate clinical context 1 . Dermoscopy is often a very helpful noninvasive tool in EPDS, but it may not show diagnostic clues, and sometimes histopathologic confirmation is necessary 2 …”

Section: Figurementioning

confidence: 99%

“…Erosive pustular dermatosis of the scalp (EPDS), a rare underdiagnosed inflammatory disease with predilection for elderly patients with androgenetic alopecia, severe actinic damage, and/or a history of trauma to the scalp, is characterized by recurrent small pustules, erosions, and more or less thickened gray-yellowish scales that can lead to scarring alopecia secondary to hair follicle destruction. [1][2][3] An 81-year-old man was referred with a 2-month history of multiple painful thick, yellow-brownish crusts on the bald areas of the scalp (Fig. 1a).…”

Section: Topical Zinc Oxide: Breaking the Vicious Cycle Of Erosive Pu...mentioning

confidence: 99%

“…1 Dermoscopy is often a very helpful noninvasive tool in EPDS, but it may not show diagnostic clues, and sometimes histopathologic confirmation is necessary. 2 The exact etiopathogenesis of EPDS remains not completely understood, although possible hypotheses include an impaired mechanism of wound healing induced by local trauma, either alone or in combination with predisposing factors like skin atrophy and actinic damage, and an immune dysregulation toward the hair follicles with subsequent chronic inflammation and scarring. Although several therapeutic strategies have been proposed (topical tacrolimus, dapsone gel, and photodynamic therapy), none of these treatments have proven to be really effective, with the exception of high-potency topical corticosteroids, which guarantee a complete wound healing in almost 80% of patients.…”

Section: Topical Zinc Oxide: Breaking the Vicious Cycle Of Erosive Pu...mentioning

confidence: 99%

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