Erosive Pustular Dermatosis of the Scalp Mimicking Squamous Cell Carcinoma: Can Dermoscopy Be Helpful?

April 2025 in “ Dermatology Practical & Conceptual ”

Camila Scharf, Aleksandra Stefaniak, Mario Vaccaro, Francesco Borgia, Federico Vaccaro, Fabrizio Chirico, A Battisti, Valentino Valentini, Giuseppe Argenziano

Erosive Pustular Dermatosis of the Scalp Squamous Cell Carcinoma dermoscopy histology biopsy targetoid structures polymorphic vessels

Studysummary This study found that erosive pustular dermatosis of the scalp is often misdiagnosed as squamous cell carcinoma, highlighting the importance of biopsy for accurate diagnosis. Our plain-language summary of this paper — not a Tressless recommendation.

The study investigates the diagnostic challenges of Erosive Pustular Dermatosis of the Scalp (EPDS), which often mimics Squamous Cell Carcinoma (SCC). Conducted in two Italian dermatological centers from 2017 to 2023, the retrospective cohort study included 43 patients initially diagnosed with SCC, later confirmed as EPDS through histology. The study found that EPDS is frequently misdiagnosed as SCC due to similar clinical and dermoscopic features, such as targetoid structures and polymorphic vessels. The findings emphasize the importance of biopsy for accurate diagnosis to prevent unnecessary treatments, as clinical and dermoscopic criteria alone may not be specific enough to distinguish between EPDS and SCC.

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Research cited in this study

6 / 6 results

research Erosive Pustular Dermatosis of the Scalp: Causes and Treatments

13 citations , June 2020 in “International Journal of Dermatology”

This review discusses erosive pustular dermatosis of the scalp, highlighting its wide variety of causes and multiple effective treatment options beyond high-potency topical steroids, and reports no new clinical results.

research Erosive Pustular Dermatosis of the Scalp: A Multicenter Study

18 citations , January 2020 in “Journal of the European Academy of Dermatology and Venereology”

This study identified trichoscopy as a key diagnostic tool for erosive pustular dermatosis of the scalp and suggested high-potency steroids or tacrolimus as effective first-line treatments.

research Erosive Pustular Dermatosis of the Scalp: A Neutrophilic Folliculitis Within the Spectrum of Neutrophilic Dermatoses

25 citations , October 2018 in “Journal of The American Academy of Dermatology”

This study concluded that erosive pustular dermatosis of the scalp may be a type of spongiotic, pustular superficial folliculitis, sharing similarities with other neutrophilic dermatoses.

research Erosive Pustular Dermatosis of the Scalp: Clinical, Trichoscopic, and Histopathologic Features of 20 Cases

53 citations , February 2017 in “Journal of The American Academy of Dermatology”

In this study of 20 patients with erosive pustular dermatosis of the scalp, using trichoscopy improved diagnosis, and treatments with high-potency steroids or topical tacrolimus effectively reduced inflammatory signs, suggesting these as first-line treatments.

research Erosive Pustular Dermatosis (Chronic Atrophic Dermatosis of the Scalp and Extremities)

34 citations , July 2013 in “Clinical Cosmetic and Investigational Dermatology”

This study observed that while topical drug therapy for erosive pustular dermatosis rarely leads to complete resolution, surgery may achieve remission in male patients.

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

49 citations , January 2005 in “Dermatology”

This case study found that isotretinoin treatment achieved complete resolution of erosive pustular dermatosis of the scalp in a patient, suggesting systemic retinoids as a potential treatment option.