Post-traumatic erosive dermatosis of the scalp: A hypergranulated variant

Australas J Dermatol. 2019 Nov;60(4):e322-e326. doi: 10.1111/ajd.13099. Epub 2019 Jun 27.


Erosive pustular dermatosis of the scalp is a slowly progressive chronic inflammatory disease that predominantly affects elderly male patients with marked actinic damage. The clinical evolution consists firstly of keratotic and erosive plaques surmounted by yellow-brown crusts and non-follicular pustules; later, the active crusting lesions regress in number and the scarring process causes diffuse cutaneous thinning and loss of hair follicles. However, manifestations may be atypical, leading to frequent misdiagnosis. We present a case series of post-traumatic erosive pustular dermatosis on the scalp of 4 elderly patients. The characterising feature was the presence of erosion consisting of abundant hypergranulation tissue, with an almost total lack of crusts and pustules. Dermoscopy showed a unique pattern of stretched and dilated linear, telangiectatic and polymorphous on-focus vessels, milky-red areas and white scarring areas. This clinical entity is rarely reported in the literature. The majority of reported cases were located on the legs.

Keywords: dermoscopy; scalp dermatosis.

Publication types

  • Case Reports

MeSH terms

  • Administration, Topical
  • Aged
  • Aged, 80 and over
  • Anti-Bacterial Agents / therapeutic use
  • Betamethasone / therapeutic use
  • Dermoscopy
  • Fusidic Acid / therapeutic use
  • Glucocorticoids / therapeutic use
  • Humans
  • Male
  • Scalp / injuries*
  • Scalp Dermatoses / drug therapy
  • Scalp Dermatoses / etiology*
  • Scalp Dermatoses / pathology*
  • Skin Diseases, Vesiculobullous / drug therapy
  • Skin Diseases, Vesiculobullous / etiology*
  • Skin Diseases, Vesiculobullous / pathology*


  • Anti-Bacterial Agents
  • Glucocorticoids
  • Fusidic Acid
  • Betamethasone