Erosive Pustulosis of the Scalp Clinical Presentation

Updated: Aug 06, 2019
  • Author: David T Robles, MD, PhD, FAAD; Chief Editor: Dirk M Elston, MD  more...
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In erosive pustulosis of the scalp patients, a history of trauma or long-term sun exposure to the affected area can usually be established. Erosive pustulosis of the scalp is generally chronic and may have associated pruritus and/or pain. Patients with extremity involvement may report a history of chronic leg ulcers or chronic venous insufficiency. [19]


Physical Examination

Patients present with varying degrees of scarring associated with yellow-brown crusts, erosions, purulent drainage, pustules, and lakes of pus. Pustules may not be visualized, and, when seen, they are usually flattened and contain little or no fluid. Skin surrounding the erosions is almost always atrophic. Purulence may suggest infection, but edema, warmth, and regional lymphadenopathy are typically absent. [6]



Malignancy may develop in areas involved by erosive pustulosis of the scalp. Additionally, recurrence of erosive pustulosis of the scalp has been reported with cessation of treatment, but it tends to respond well to restarting the initial treatment. [5] Secondary infection may also occur.