Jin Seop Kim
Sungkyunkwan University School of Medicine, Korea
Title: Erosive Pustular Dermatosis of the Scalp Arising on the Long-standing Burn Scars : A Report of Three Cases
Biography
Biography: Jin Seop Kim
Abstract
Erosive pustular dermatosis of the scalp (EPDS) is clinically characterized by a chronic eruption of scalp pustules, erosions and crusts that leads to scarring alopecia. Previous literatures have reported association between EPDS and predisposing factors like skin atrophy and trauma. However, EPDS after childhood burn has never been reported.
Three female patients were presented with erosions, crusts, and painful ulceration on the burn scars of the scalp that occurred in childhood. To exclude malignancy on old burn scars, we performed punch biopsies. In all cases, histopathological examination showed inflamed crust, ulcer, acanthosis and neutrophilic infiltration. Based on the clinical and histopathological features, EPDS has diagnosed. Treatment with clobetasol propionate and 0.1% tacrolimus oint has effect on regression of inflammatory sign.
Although the exact pathogenesis of EPDS is unknown, aberrant wound healing response including insufficient blood flow, necrosis, or even autoimmunity has been suggested. Healed burn scar is more vulnerable to continued inury, because it has less elastic covering. Repetitive irritation might trigger an autoimmune reaction to unknown skin antigens. Because EPDS has common and nonspecific clinical presentation, EPDS could be misdiagnosed. We have suggested when clinicians encounter erosive dermatosis in long standing burn scar, clinicians should consider EPDS in differential diagnosis.