Close
New

Medscape is available in 5 Language Editions – Choose your Edition here.

 

Erosive Pustulosis of the Scalp Treatment & Management

  • Author: Kristin L Eastman, MD; Chief Editor: Dirk M Elston, MD  more...
 
Updated: Aug 05, 2014
 

Medical Care

Erosive pustulosis of the scalp is a chronic condition requiring long-term management. The mainstay of treatment has been high-potency topical steroids, and frequently the condition responds rapidly.[5, 6] Topical tacrolimus ointment has also been reported to be helpful.[9, 12, 13, 14] Other treatments reported to be effective include topical and oral retinoids, topical calcipotriol, and oral zinc sulfate, but experience is limited and results appear varied.[3, 4] Although erosive pustulosis of the scalp has been reported to be caused by photodynamic therapy, it has also been reported to resolve with photodynamic therapy in another patient.[15] In addition to the aforementioned therapies, some have also removed the overlying crust prior to application of topical medications by softening it with a physiological solution and then rinsing with 3% boric acid.[16]

Erosive pustulosis of the scalp patients should continue to be observed because carcinomas such as squamous cell carcinoma and basal cell carcinoma have been reported to arise secondarily in some cases.[17]

Next

Surgical Care

Surgery is not considered a treatment method for erosive pustulosis of the scalp and should be avoided.

Previous
Next

Consultations

Consultation with a dermatologist should be considered.

Previous
Next

Diet

No special dietary needs are required in erosive pustulosis of the scalp.

Previous
Next

Activity

No activity restrictions are necessary in erosive pustulosis of the scalp.

Previous
 
 
Contributor Information and Disclosures
Author

Kristin L Eastman, MD Resident Physician, Department of Dermatology, University of Wisconsin School of Medicine and Public Health

Kristin L Eastman, MD is a member of the following medical societies: American Academy of Dermatology, American Society for Dermatologic Surgery, Women's Dermatologic Society, Chicago Dermatological Society, Wisconsin Dermatological Society

Disclosure: Nothing to disclose.

Coauthor(s)

Daniel D Bennett, MD Assistant Professor, Department of Dermatology, University of Wisconsin School of Medicine and Public Health

Daniel D Bennett, MD is a member of the following medical societies: American Academy of Dermatology, American Medical Association, Society for Investigative Dermatology, Dermatology Foundation

Disclosure: Nothing to disclose.

Specialty Editor Board

David F Butler, MD Section Chief of Dermatology, Central Texas Veterans Healthcare System; Professor of Dermatology, Texas A&M University College of Medicine; Founding Chair, Department of Dermatology, Scott and White Clinic

David F Butler, MD is a member of the following medical societies: American Medical Association, Alpha Omega Alpha, Association of Military Dermatologists, American Academy of Dermatology, American Society for Dermatologic Surgery, American Society for MOHS Surgery, Phi Beta Kappa

Disclosure: Nothing to disclose.

Warren R Heymann, MD Head, Division of Dermatology, Professor, Department of Internal Medicine, Rutgers New Jersey Medical School

Warren R Heymann, MD is a member of the following medical societies: American Academy of Dermatology, American Society of Dermatopathology, Society for Investigative Dermatology

Disclosure: Nothing to disclose.

Chief Editor

Dirk M Elston, MD Professor and Chairman, Department of Dermatology and Dermatologic Surgery, Medical University of South Carolina College of Medicine

Dirk M Elston, MD is a member of the following medical societies: American Academy of Dermatology

Disclosure: Nothing to disclose.

Additional Contributors

Kathryn Schwarzenberger, MD Associate Professor of Medicine, Division of Dermatology, University of Vermont College of Medicine; Consulting Staff, Division of Dermatology, Fletcher Allen Health Care

Kathryn Schwarzenberger, MD is a member of the following medical societies: Women's Dermatologic Society, American Contact Dermatitis Society, Medical Dermatology Society, Dermatology Foundation, Alpha Omega Alpha, American Academy of Dermatology

Disclosure: Nothing to disclose.

Acknowledgements

Cary Chisholm, MD Dermatopathology Fellow, Department of Dermatology, University of Texas Southwestern Medical Center

Cary Chisholm, MD is a member of the following medical societies: College of American Pathologists, Texas Medical Association, and United States and Canadian Academy of Pathology

Disclosure: Nothing to disclose.

Eiriny M Tadros, MD Resident Physician, Department of Internal Medicine, Baylor College of Medicine

Eiriny M Tadros, MD is a member of the following medical societies: American College of Physicians, American Medical Association, and Texas Medical Association

Disclosure: Nothing to disclose.

References
  1. Pye RJ, Peachey RD, Burton JL. Erosive pustular dermatosis of the scalp. Br J Dermatol. 1979 May. 100(5):559-66. [Medline].

  2. Semkova K, Tchernev G, Wollina U. Erosive pustular dermatosis (chronic atrophic dermatosis of the scalp and extremities). Clin Cosmet Investig Dermatol. 2013. 6:177-82. [Medline]. [Full Text].

  3. Van Exel CE, English JC 3rd. Erosive pustular dermatosis of the scalp and nonscalp. J Am Acad Dermatol. 2007 Aug. 57(2 Suppl):S11-4. [Medline].

  4. Patton D, Lynch PJ, Fung MA, Fazel N. Chronic atrophic erosive dermatosis of the scalp and extremities: A recharacterization of erosive pustular dermatosis. J Am Acad Dermatol. 2007 Sep. 57(3):421-7. [Medline].

  5. Aigner B, Legat FJ, Schuster C, El Shabrawi-Caelen L. Sun-induced Pustular Dermatosis of the Scalp - A New Variant of Erosive Pustular Dermatosis of the Scalp?. Acta Derm Venereol. 2013 Nov 21. [Medline].

  6. Al-Benna S, Johnson K, Perkins W, O'Boyle C. Erosive pustular dermatosis: new description of a possible cause of the non-healing burn wound. Burns. 2014 Jun. 40(4):636-40. [Medline].

  7. Guarneri C, Vaccaro M. Erosive pustular dermatosis of the scalp following topical methylaminolaevulinate photodynamic therapy. J Am Acad Dermatol. 2009 Mar. 60(3):521-2. [Medline].

  8. Tavares-Bello R. Erosive pustular dermatosis of the scalp. A chronic recalcitrant dermatosis developed upon CO2 laser treatment. Dermatology. 2009. 219(1):71-2. [Medline].

  9. Marzano AV, Ghislanzoni M, Zaghis A, Spinelli D, Crosti C. Localized erosive pustular dermatosis of the scalp at the site of a cochlear implant: successful treatment with topical tacrolimus. Clin Exp Dermatol. 2009 Jul. 34(5):e157-9. [Medline].

  10. Erdmann M, Kiesewetter F, Schuler G, Schultz E. Erosive pustular dermatosis of the leg in a patient with ankylosing spondylitis: neutrophilic dysfunction as a common etiological factor?. Int J Dermatol. 2009 May. 48(5):513-5. [Medline].

  11. Mehmi M, Abdullah A. Erosive pustular dermatosis of the scalp occurring after partial thickness skin graft for squamous cell carcinoma. Br J Plast Surg. 2004 Dec. 57(8):806-7. [Medline].

  12. Laffitte E, Kaya G, Piguet V, Saurat JH. Erosive pustular dermatosis of the scalp: treatment with topical tacrolimus. Arch Dermatol. 2003 Jun. 139(6):712-4. [Medline].

  13. Seez M, Rodriguez-Martín M, Sidro M, Carnerero A, Garcia-Bustínduy M, Noda A. Successful treatment of erosive pustular dermatosis of the scalp with topical tacrolimus. Clin Exp Dermatol. 2005 Sep. 30(5):599-600. [Medline].

  14. Zahdi MR, Seidel GB, Soares VC, Freitas CF, Mulinari-Brenner FA. Erosive pustular dermatosis of the scalp successfully treated with oral prednisone and topical tacrolimus. An Bras Dermatol. 2013 Sep-Oct. 88(5):796-8. [Medline]. [Full Text].

  15. Meyer T, Lopez-Navarro N, Herrera-Acosta E, Jose A, Herrera E. Erosive pustular dermatosis of the scalp: a successful treatment with photodynamic therapy. Photodermatol Photoimmunol Photomed. 2010 Feb. 26(1):44-5. [Medline].

  16. Levakov O, Gajic B. Erosive pustular dermatosis of the scalp-is it really a rare condition?. Vojnosanit Pregl. 2014 Mar. 71(3):307-10. [Medline].

  17. Allevato M, Clerc C, del Sel JM, Donatti L, Cabrera H, Juarez M. Erosive pustular dermatosis of the scalp. Int J Dermatol. 2009 Nov. 48(11):1213-6. [Medline].

  18. Ikeda M, Arata J, Isaka H. Erosive pustular dermatosis of the scalp successfully treated with oral zinc sulphate. Br J Dermatol. 1982 Jun. 106(6):742-3. [Medline].

Previous
Next
 
Yellow-brown crusts with atrophy on the vertex scalp.
Yellow-brown crusts on the vertex scalp.
A dense perifollicular infiltrate is composed of lymphocytes, neutrophils, histiocytes, and multinucleated giant cells (hematoxylin and eosin, 200x).
Closer examination shows a predominantly neutrophilic infiltrate with a background of admixed lymphocytes and histiocytes (hematoxylin and eosin, 400x).
 
 
 
All material on this website is protected by copyright, Copyright © 1994-2016 by WebMD LLC. This website also contains material copyrighted by 3rd parties.