Chronic Crusted Scalp Lesion of an Elderly Male

Gamret, A. Caresse; Fertig, Raymond; Darwin, Evan; Klingbeil, Kyle D.; Sanik, Eugene; Gaudi, Sudeep

doi:10.1159/000485569

Cited by 2 publications

(1 citation statement)

References 8 publications

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“…Twenty‐two studies, involving 79 patients, reported outcomes for TCS used as monotherapy 3–33. Where stated, the median duration of treatment was 6 weeks (IQR 3–10).…”

Section: Resultsmentioning

confidence: 99%

Therapeutic options for erosive pustular dermatosis of the scalp: a systematic review*

et al. 2020

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Summary Background Erosive pustular dermatosis of the scalp (EPDS) is a chronic condition characterized by erosive plaques and subsequent scarring alopecia as a result of local trauma or inflammation. A number of therapeutic approaches have been described in the literature but there is no consensus of opinion on optimal treatment of the disease. Objectives To provide evidence‐based recommendations for topical and systemic treatment of adult patients with EPDS by performing a systematic review. Methods The MEDLINE, MEDLINE In‐Process, Embase and Cochrane databases were searched from inception to 26 June 2019 in accordance with the PRISMA guidelines for studies involving adult patients treated for EPDS with at least one reported response to treatment. The study was registered on PROSPERO. Texts were reviewed independently by two authors. The risk of bias and quality of the studies were assessed using the Quality Appraisal Checklist for Case Series Studies. Results In total 75 studies were included, involving 168 patients. Many treatments have been reported in the literature, with varying degrees of therapeutic success. The results were highly heterogeneous and methodological quality was very low. We were unable to perform a meta‐analysis on the data. Conclusions The limited available evidence supports use of topical corticosteroids, with or without oral zinc, followed by maintenance therapy with topical calcineurin inhibitors as being effective in managing this condition. Topical photodynamic therapy is also potentially beneficial in the management of EPDS. Prospective, comparative, randomized controlled trials are required in order to provide further evidence to guide treatment.

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“…Twenty‐two studies, involving 79 patients, reported outcomes for TCS used as monotherapy 3–33. Where stated, the median duration of treatment was 6 weeks (IQR 3–10).…”

Section: Resultsmentioning

confidence: 99%

Therapeutic options for erosive pustular dermatosis of the scalp: a systematic review*

et al. 2020

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Treatment of erosive pustular dermatosis: a systematic review of the literature

et al. 2020

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ImportanceErosive pustular dermatosis (EPD) is a rare chronic inflammatory condition of the scalp and legs that is often difficult to manage. Currently, there are no treatment guidelines.ObjectiveTo systematically assess the existing literature on various treatment modalities and their efficacies when used in the management of EPD.Evidence reviewWe searched PubMed, Cochrane Libraries, Scopus, and clicnialtrial.gov databases for articles in the English language with no limited time frame. Emphasis was placed on articles that reported on treatment for EPD.FindingsOf the 168 articles identified by the literature search, 92 met eligibility criteria and were included for qualitative analysis. Efficacious topical treatments included clobetasol, betamethasone, and tacrolimus. Ninety‐three and 88% of cases utilizing clobetasol and betamethasone respectively demonstrated improvement or resolution. All 32 cases utilizing tacrolimus reported improvement. Efficacious systemic treatments included oral steroids such as prednisone, methylprednisolone, and dexamethasone. Topical dapsone, photodynamic therapy, systemic steroids, cyclosporine, and oral zinc derivatives were also described with some success.Conclusions and relevanceAccording to available data, limited solely to case reports and case series, potent topical steroids are an effective treatment option for EPD. Topical tacrolimus may also be considered in cases that require long‐term use or maintenance. Other treatment modalities shown to be successful based on high reported efficacy and low rates of recurrence after treatment include topical dapsone, systemic steroids, zinc derivatives, and cyclosporine. Further studies are needed to compare treatment modalities and to establish treatment protocols.

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Chronic Crusted Scalp Lesion of an Elderly Male

Cited by 2 publications

References 8 publications

Therapeutic options for erosive pustular dermatosis of the scalp: a systematic review*

Therapeutic options for erosive pustular dermatosis of the scalp: a systematic review*

Treatment of erosive pustular dermatosis: a systematic review of the literature

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