Erosive pustular dermatosis of the scalp following cryotherapy and topical tretinoin for actinic keratoses

Rongioletti, Franco; Delmonte,; Rossi, Laura Lucia; Strani,; Rebora, Alfredo

doi:10.1046/j.1365-2230.1999.00546.x

Cited by 55 publications

(53 citation statements)

References 5 publications

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“…Topical retinoids and photodynamic therapy have mixed reports of both improving and worsening EPDS. 2,23,25,29 The recent literature supports the efficacy of topical tacrolimus for management of EPDS. 7,9,21,27,28 The safety of topical dapsone along with efficacy demonstrated by our 4 patient cases suggests that topical dapsone should be considered in the treatment of EPDS.…”

Section: Discussionmentioning

confidence: 97%

Erosive pustular dermatosis of the scalp: A review with a focus on dapsone therapy

Broussard¹,

Berger²,

Rosenblum³

et al. 2012

Journal of the American Academy of Dermatology

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Section: Discussionmentioning

confidence: 97%

Erosive pustular dermatosis of the scalp: A review with a focus on dapsone therapy

Broussard¹,

Berger²,

Rosenblum³

et al. 2012

Journal of the American Academy of Dermatology

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“…Since the first descriptions by Burton [1] and Pye et al [2], few cases have been observed [3,4,5,6,7,8,9]. This cutaneous disease affects prevalently adults with a male/female sex ratio of 3:2 [11]. The pathogenesis remains unknown, but predisposing factors such as recent or past local trauma, skin grafting and excessive exposure to sunlight on the bald scalp [12] have been reported.…”

Section: Discussionmentioning

confidence: 99%

“…Later on, other cases [3,4,5,6,7,8,9] have been described improving the knowledge about this pathology which still remains uncommon in the clinical practice. The female/male sex ratio is actually 2:3 [10, 11]. It affects prevalently elderly white women.…”

Section: Introductionmentioning

confidence: 99%

Erosive Pustular Dermatosis of the Scalp: A Case Report and Review of the Literature

et al. 2005

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Erosive pustular dermatosis of the scalp (EPDS) is a rare entity characterized by pustular, erosive and crusted lesions of the scalp with progressive scarring alopecia. The aetiology is unknown, but predisposing factors have been reported such as trauma, skin grafting, prolonged exposure to UV light of a bald scalp as well as co-existence of auto-immune diseases. Laboratory data, bacteriological and mycological investigations and histopathology are generally not diagnostic. A 45-year-old Caucasian man with 1-year-old pustular, erosive and crusted lesions on his bald scalp was seen. Laboratory data, including auto-immunity, bacteriological and mycological investigations were negative. Histopathology was not diagnostic showing a diffuse polymorphous infiltrate involving the dermis. A diagnosis of EPDS was made. The patient was treated with topical and systemic antibiotics and steroids as well as oral nimesulide with no or partial response. Consequently, isotretinoin (0.75 mg/kg/day) was started obtaining complete resolution in few months. No relapse after 1 year of follow-up was seen. EPDS represents a distinct disease with a history of relapsing and unsatisfactory response to common treatments. Systemic retinoids may be considered as a potentially resolutive choice.

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“…Response to antibiotics is poor, but the condition is suppressed by potent topical steroids, suggesting an inflammatory rather than an infective etiology. The condition has been observed following contusion, laceration, blistering sunburn, shingles, synthetic fiber implantation, craniotomy and skin grafting of the scalp [15], as well as following treatment of solar keratoses with 5% topical fluorouracil cream, cryotherapy and topical tretinoin [16]and soft X-ray therapy [17]. Response to therapy has been variable, with best responses to potent topical steroids, and more recently to topical 0.1% tacrolimus [18].…”

Section: Disorders Of the Photodamaged Scalpmentioning

confidence: 99%

Is Androgenetic Alopecia a Photoaggravated Dermatosis?

Trüeb

2003

Dermatology

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Progressive thinning of the scalp hair in androgenetic alopecia (AGA) results in a gradual decline in natural protection of the scalp from ultraviolet radiation (UVR). A number of pathologic conditions of the scalp are evidently related to UVR, particularly photosensitive diseases and disorders of the chronically photodamaged bald scalp. The most important chronic effects of UVR are photocarcinogenesis and solar elastosis. Besides these, erosive pustular dermatosis and ‘red scalp’ are distinct disorders peculiar to the balding scalp. While the consequences of sustained UVR on the unprotected scalp are well appreciated, the effects of UVR on hair loss have widely been ignored. However, clinical observations and theoretical considerations suggest that UVR may have negative effects: acute telogen effluvium from UVR has been described, and the production of porphyrins by Propionibacterium sp. in the pilosebaceous duct, with photoactivation of porphyrins leading to oxidative tissue injury, has been implicated in follicular microinflammation. Alternatively, keratinocytes themselves may respond to physicochemical stress from UVR, besides irritants and pollutants, by producing radical oxygen species and nitric oxide and by releasing proinflammatory cytokines, eventually leading to injury of the putative site of follicular stem cells in the superficial portion of the hair follicle. Since all of these processes involved in hair loss share the common feature that they are induced or exacerbated by exposure to sunlight, it is proposed that AGA is a photoaggravated dermatosis that requires photoprotection.

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Erosive pustular dermatosis of the scalp following cryotherapy and topical tretinoin for actinic keratoses

Cited by 55 publications

References 5 publications

Erosive pustular dermatosis of the scalp: A review with a focus on dapsone therapy

Erosive pustular dermatosis of the scalp: A review with a focus on dapsone therapy

Erosive Pustular Dermatosis of the Scalp: A Case Report and Review of the Literature

Is Androgenetic Alopecia a Photoaggravated Dermatosis?

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