Dermatosis pustulosa erosiva del cuero cabelludo

Abstract

Abstract—Erosive pustular dermatosis of the scalp is a disease characterized by eroded, crusted and pustular lesions resulting in scarring alopecia. It usually occurs in 60 to 90 year old patients. Histopathology is nonspecific, showing an atrophic, eroded epidermis, subcorneal pustules, and an infiltrate of lymphocytes, plasmocytes and, less frequently, neutrophils and giant cells. Inmunofluorescence and microbiological studies are negative. The differential diagnoses include bacterial or fungal infections, discoid lupus erythematosus, lichen planus, and cicatricial pemphigoid. The treatment is difficult, and potent topical steroids under occlusion are sometimes effective. Oral zinc sulphate, isotretinoin, dapsona have been anecdotally active.We report two patients with pustular dermatosis confined to the scalp, who developed chronic, extensive, pustular, crusted lesions of the scalp which produced scarring alopecia. Studies were essentially negative and skin biopsies showed only nonspecific changes. The condition did not respond to antibiotics, but was suppressed by potent topical steroids.