Successful use of a fractional 2940-nm laser in treating chronic, severe erosive pustular dermatosis of the scalp

Grubbs, Hailey; Robb, Chris W.

doi:10.1016/j.jdcr.2018.11.003

Cited by 7 publications

(8 citation statements)

References 9 publications

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“…23,24 Recently, it was also suggested a fractional ablative laser (erbium YAG) therapy as a possible treatment but the rationale is still unknown. 25 Table 2 shows the previously reported data in literature regarding EPDS, underlining the main observations emerged from our study (mean age, prevalence in sexes, clinical, trichoscopic and histopatological data and therapy suggestions). In addition, recently a lot of clinical studies of personal experience of different dermatologic clinics are reported to underline the increasing of this hair disease.…”

Section: Discussionmentioning

confidence: 75%

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Erosive pustular dermatosis of the scalp: a multicentre study

Starace

Iorizzo²,

Trüeb³

et al. 2020

Acad Dermatol Venereol

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Background Erosive pustular dermatosis of the scalp (EPDS) is characterized by crusted erosions or superficial ulcerations that lead to scarring alopecia. Objectives and Methods We performed a multicentre retrospective clinical study including 56 patients (29 females and 27 males, mean age 62.7) with a confirmed EPDS in order to describe epidemiology, clinical findings and therapeutic choices of this disease. Results Mechanical/chemical trauma was reported in 28.6%, a previous infection in 10.7%, a previous cryotherapy in 5.4% androgenetic alopecia in 48.2% and severe actinic damage in 25%. Trichoscopy showed absence of follicular ostia, tufted and broken hair, crusts, serous exudate, dilated vessels, pustules and hyperkeratosis. Histopathology revealed three different features, depending on the disease duration. The most prescribed therapy was topical steroids (62.5%), followed by the combination of topical steroids and topical tacrolimus (8.9%), systemic steroids (7.1%) and topical tacrolimus (5.4%). A reduction of inflammatory signs was observed in 28 patients (50%) treated with topical steroids and in all three patients treated with topical tacrolimus. Conclusion The relatively high number of patients collected allowed us to identify a better diagnostic approach, using trichoscopy and a more effective therapeutic strategy, with high-potency steroids or tacrolimus, which should be considered as first-line treatment.

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Section: Discussionmentioning

confidence: 75%

“…Recently, it was also suggested a fractional ablative laser (erbium YAG) therapy as a possible treatment but the rationale is still unknown …”

Section: Discussionmentioning

confidence: 99%

Erosive pustular dermatosis of the scalp: a multicentre study

Starace

Iorizzo²,

Trüeb³

et al. 2020

Acad Dermatol Venereol

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“…Complete resolution was achieved in four patients (80%) and one patient had stable disease. Topical antibiotics were used as part of combination therapy in 16 studies involving 17 patients 31–69. The most commonly used topical antibiotics were dapsone (five cases) and gentamicin (five cases).…”

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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“…Interestingly, fractional laser has even been reported as an effective treatment modality for EPD of the scalp. 4 While our patient failed many of the aforementioned topical and systemic medications, she started to improve on 20 mg of acetretin daily with complete resolution after 3 months.…”

mentioning

confidence: 76%