2013
DOI: 10.1590/abd1806-4841.20132109
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Erosive pustular dermatosis of the scalp successfully treated with oral prednisone and topical tacrolimus

Abstract: Erosive pustular dermatosis of the scalp is a rare inflammatory disorder of the scalp, affecting elderly patients after local trauma and leading to scarring or cicatricial alopecia. Case Report: An elderly female patient complained of painful pustules on the parietal region bilaterally with progressive enlargement and ulceration. A biopsy suggested erosive pustular dermatosis of the scalp and the patient was treated with prednisone 40 mg/day and 0.1% topical tacrolimus. After 10 weeks complete closure of the e… Show more

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Cited by 19 publications
(23 citation statements)
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References 9 publications
(18 reference statements)
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“…The age-related over-activation of the innate immune system described above, combined with the inability to properly heal wounds, may contribute to the chronic presentation of EPD. That the driving force of the disease is the exaggerated immune response is evidenced by a recent report of concomitant elevation of serum matrix metalloproteinase-3 in patients with EPD [34] and multiple cases that have been successfully treated with immunosuppressive therapies [2,35,36,37]. Amplification of the immune reaction can also be triggered by topical treatments used in dermatology including imiquimod, 5-fluorouracil, and ingenol mebutate, which have been reported to cause EPD in chronically sun-damaged patients [8,38,39].…”
Section: Discussionmentioning
confidence: 99%
See 1 more Smart Citation
“…The age-related over-activation of the innate immune system described above, combined with the inability to properly heal wounds, may contribute to the chronic presentation of EPD. That the driving force of the disease is the exaggerated immune response is evidenced by a recent report of concomitant elevation of serum matrix metalloproteinase-3 in patients with EPD [34] and multiple cases that have been successfully treated with immunosuppressive therapies [2,35,36,37]. Amplification of the immune reaction can also be triggered by topical treatments used in dermatology including imiquimod, 5-fluorouracil, and ingenol mebutate, which have been reported to cause EPD in chronically sun-damaged patients [8,38,39].…”
Section: Discussionmentioning
confidence: 99%
“…The mainstay of treatment is immunosuppression with topical superpotent corticosteroids or systemic prednisone. Other topical regimens that have been successfully used include topical calcineurin inhibitors [36,55,56]. Topical [57] and systemic dapsone [2] have also been used to address the abnormally exaggerated immune reaction in these patients.…”
Section: Treatmentmentioning
confidence: 99%
“…El curso clínico es variable, en general tiene un curso lento y progresivo con erosiones, pústulas y costras que tienden a la cronicidad, que en meses o años pueden afectar extensas áreas de la piel, llevando a provocar alopecia cicatricial 9 . Excepcionalmente, en casos de muchos años de evolución se ha descrito la presencia de carcinoma sobre este proceso 10 , por lo que es recomendable la detección, tratamiento y seguimiento oportuno de esta patología.…”
Section: Figuraunclassified
“…Podstawą leczenia są miejscowe preparaty glikokortykosteroidowe dające szybką remisję. Takrolimus stosowany miejscowo również przynosi bardzo dobre efekty terapeutyczne, zwłasz-cza w terapii przewlekłej [5][6][7][8]. Choroba jest rzadko rozpoznawana ze względu na trudności diagnostyczne, nie ma bowiem charakterystycznych wyznaczników laboratoryjnych i patognomonicznych cech histopatologicznych [9].…”
Section: Wprowadzenieunclassified
“…Najbardziej efektywną metodą leczenia wydaje się stosowanie zewnętrz-nych preparatów glikokortykosteroidowych, takrolimusu oraz miejscowych pochodnych witaminy D 3 (kalcypotriol). W terapii ogólnej zaleca się przyjmowanie sulfonów, retinoidów, soli cynku oraz terapię fotodynamiczną [6,8,10,11]. Antybiotykoterapia przynosi poprawę, nie wpływa jednak na aktywność zasadniczego procesu chorobowego.…”
Section: Omówienieunclassified