Erosive Pustular Dermatosis of the Scalp After Contact Dermatitis from a Prosthetic Hair Piece

In 2017, a case was reported of a 58-year-old woman who developed erosive pustular dermatosis of the scalp (EPDS) after experiencing contact dermatitis from a glued-on prosthetic hair piece. This condition, characterized by pustules, erosions, and crusting leading to scarring alopecia, was previously associated with local injuries and certain medications but not with contact dermatitis from hair pieces. The patient initially responded to topical corticosteroids, but her condition worsened upon discontinuation, with new lesions forming. Subsequent treatment with oral prednisone and continued topical corticosteroids was ineffective. However, the condition improved with topical tacrolimus 0.1% ointment, leading to some hair regrowth, although large areas of alopecia persisted. This case was the first reported instance of EPDS following contact dermatitis unrelated to topical medications, suggesting that contact dermatitis should be considered a potential trigger for EPDS. Dermatologists were advised to be aware of this to prevent misdiagnosis.