Two Cases of Severe Erosive Pustular Dermatosis Mimicking Infection

Wounds. 2018 Aug;30(8):E84-E86.

Abstract

Introduction: Erosive pustular dermatosis of the scalp (EPDS) is a noninfectious inflammatory disorder characterized by pustules, erosions, ulcerations, and crusted erythematous plaques that is often associated with mechanical or chemical trauma. While its appearance may mimic infection, its etiology is thought to have an autoimmune component based on responsiveness to immunomodulators.

Case report: Herein, the authors present 2 cases of EPDS that were initially treated as primary infections. In both cases, the wounds did not respond to antimicrobial treatment and led to severe ulceration, exposing cranial bone. Both wounds improved with topical corticosteroid therapy.

Conclusions: These cases represent the importance of considering topical steroid treatment and a diagnosis of EPDS after debridement for purulent scalp ulcers.

Publication types

  • Case Reports

MeSH terms

  • Administration, Topical
  • Adrenal Cortex Hormones / therapeutic use*
  • Aged, 80 and over
  • Anti-Bacterial Agents / adverse effects
  • Debridement / methods
  • Diagnosis, Differential
  • Diagnostic Errors / adverse effects
  • Female
  • Humans
  • Male
  • Scalp / pathology*
  • Scalp Dermatoses / diagnosis*
  • Scalp Dermatoses / drug therapy
  • Skin Diseases, Vesiculobullous / diagnosis*
  • Skin Diseases, Vesiculobullous / drug therapy
  • Treatment Outcome
  • Wound Healing / physiology*

Substances

  • Adrenal Cortex Hormones
  • Anti-Bacterial Agents