Successful treatment of erosive pustular dermatosis of the scalp with topical tacrolimus

Sáez, Miguel; Rodríguez-Martín, Marina; Sidro, M; Carnerero, A; García‐Bustínduy, M.; Noda, Antonio Sedeño

doi:10.1111/j.1365-2230.2005.01864.x

Cited by 27 publications

(37 citation statements)

References 5 publications

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“…This is noteworthy bearing in mind the atrophic character of lesional skin in EPDS, which limits the usefulness of chronically administered topical steroids. Tacrolimus ointment was successfully used before in EPDS [3,10,11,12,13], as was the case in our patient who achieved a swift response and has been kept under total remission, from the 4th month on, for the 3-year follow-up period. Indeed, having in mind the chronic, recurring nature of the condition, its potential neoplastic risk, the selective involvement of chronically sun-damaged skin and, lastly, the concerns that have been brought about by the alleged tumour-promoting effects of tacrolimus, a regular and careful follow-up schedule is mandatory.…”

Section: Introductionmentioning

confidence: 85%

Erosive Pustular Dermatosis of the Scalp

Tavares‐Bello

2009

Dermatology

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Erosive pustular dermatosis of the scalp (EPDS) is a rare, chronic inflammatory dermatosis that mostly affects elderly patients, who develop erosions, pustulation, crusting and scarring on the scalp. Its aetiology remains elusive, although the role of local trauma is being emphasized. Treatment is difficult, with several topical and systemic agents being reported to induce improvement. A 63-year-old Caucasian male had been suffering from persistent painful pustules, erosions and crusts on his scalp for 2 years. The onset of the lesions followed a CO₂ laser vaporization procedure to treat multiple actinic keratoses. Different topical and systemic treatments had unsuccessfully been tried. A 4-month course of bid 0.1% tacrolimus ointment, along with strict external photoprotection, resulted in dramatic improvement, sustained after careful tapering of tacrolimus. This case is interesting in that the scalp eruption followed CO₂ laser treatment. Other cases have been associated with cryosurgery, radiotherapy, surgery, and 5-FU. In fact, to our knowledge, ours is the fourth reported case of EPDS following CO₂ laser treatment. Our case also strengthens previous observations as to the efficacy and safety of topical calcineurin inhibitors in this dermatosis. This is noteworthy bearing in mind the atrophic character of the skin in EPDS, which limits the usefulness of chronically administered topical steroids.

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Section: Introductionmentioning

confidence: 85%

Erosive Pustular Dermatosis of the Scalp

Tavares‐Bello

2009

Dermatology

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“…Tacrolimus is a potent antiinflammatory and immunosuppressive agent that has demonstrated to be effective in the management of chronic inflammatory dermatoses 11 . Recently, a few cases of successful treatment of EPDS with topical tacrolimus ointment have been reported 10,12 . After topical tacrolimus application, our case also showed rapid improvement.…”

Section: Discussionmentioning

confidence: 99%

Erosive Pustular Dermatosis of the Scalp Following Herpes Zoster: Successful Treatment with Topical Tacrolimus

et al. 2010

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Erosive pustular dermatosis of the scalp (EPDS) is a rare disorder of the elderly characterized by multiple pustular lesions with erosions and crusting that result in scarring alopecia. EPDS typically develops in aged or sun-damaged skin with a history of trauma. Histopathologically, EPDS is nonspecific, showing atrophic epidermis and chronic inflammation. Bacteriological and mycological investigations of EPDS are generally negative. Although herpes zoster is a common disorder in elderly people, previously reported cases of EPDS were rarely associated with herpes zoster. We present a rare case of EPDS following herpes zoster treated successfully with topical tacrolimus.

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“…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

Erosive pustular dermatitis of the scalp

Czajkowska¹,

Węgłowska²,

Cygan³

2015

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Przegląd Dermatologiczny 2015/6 535 STRESZCZENIE Wprowadzenie. Nadżerkowe krostkowe zapalenie skóry głowy (ang. erosive pustular dermatitis of the scalp -EPDS) jest chorobą rzadko rozpoznawaną, ponieważ nie ma charakterystycznych cech histopatologicznych, a jej obraz kliniczny przypomina wiele dermatoz występu-jących w tej lokalizacji. Dotychczas opisano około 40 przypadków tego schorzenia, które występuje głównie u osób starszych. Czynnikami predysponującymi są głównie promieniowanie ultrafioletowe, urazy i infekcje. Przebieg choroby jest przewlekły, z okresami zaostrzeń i remisji. Wykwity ustępują z bliznowaceniem oraz trwałą utratą włosów na zajętym obszarze skóry. Cel pracy. Przedstawienie przypadku EPDS obserwowanego i leczonego w naszym ośrodku. Opis przypadku. Przedstawiamy przypadek 74-letniego mężczyzny z EPDS, u którego zmiany skórne miały charakter krost, strupów i nadżerek na rumieniowym podłożu, z towarzyszącym świądem i bólem. Wykwity były zlokalizowane w okolicy czołowej, ciemieniowej oraz skroniowej. Rozpoznanie ustalono na podstawie obrazu klinicznego po wyłączeniu na podstawie przeprowadzonych badań dodatkowych i badania histopatologicznego innych jednostek chorobowych. Dobry efekt terapeutyczny uzyskano po zastosowaniu zewnętrznego glikokortykosteroidu i takrolimusu. Wnioski. Rozpoznanie EPDS jest rozpoznaniem klinicznym, które ustala się poprzez wyłączenie innych chorób zajmujących skórę owło-sioną głowy. ABSTRACTIntroduction. Erosive pustular dermatitis of the scalp is rarely diagnosed due to the uncharacteristic histopathological picture, while clinical manifestations are similar to many other dermatoses. To date, 40 cases of this disease have been described. The lesions occur most often in the elderly, triggered mainly by UV radiation, trauma and infections. The disease course is chronic, with periods of exacerbation and remission. Eruption subsides with scarring and permanent loss of hair. Objective. Presentation of a case of erosive pustular dermatosis of the scalp observed and treated in our center. Case report. We present a case of a 74-year old man with erosive pustular dermatosis of the scalp (EPDS) with pruritic and painful pustules, crusts and erosions on an erythematous base, located in the frontal, parietal, and temporal area. The diagnosis of EPDS was established on the basis of clinical manifestations after thorough differentiation with other Nadżerkowe, krostkowe zapalenie skóry głowy Erosive pustular dermatitis of the scalp

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Successful treatment of erosive pustular dermatosis of the scalp with topical tacrolimus

Cited by 27 publications

References 5 publications

Erosive Pustular Dermatosis of the Scalp

Erosive Pustular Dermatosis of the Scalp

Erosive Pustular Dermatosis of the Scalp Following Herpes Zoster: Successful Treatment with Topical Tacrolimus

Erosive pustular dermatitis of the scalp

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