“…Clinically it might be misdiagnosed as erosive pustular dermatosis of the scalp [11] or as herpes zoster, particularly if mainly the parietal branch of the temporal artery is affected. Also Wegener's granulomatosis can lead to skin ulcerations [12][13][14] . In conclusion, we strongly recommend skin biopsies in patients with recalcitrant scalp necrosis when virus detection (varicella-zoster virus) and aciclovir treatment fail and an elevated ESR as well as accompanying symptoms like headache and dysphagia are present, to determine whether the patient suffers from giant cell arteritis.…”