Erosive Pustular Dermatosis of the Scalp

Erosive pustular dermatosis of the scalp (EPDS) is a rare form of scarring alopecia that predominantly affects older adults, especially women, with a 2:1 female-to-male ratio. The condition is characterized by sterile pustules, erosions, crusting, and scarring alopecia, often following scalp trauma or damage from the sun. The largest study on EPDS included 20 patients with a mean age of 59.4 years. The cause of EPDS is unclear, but it may be related to an autoimmune reaction to scalp trauma. It is often associated with other autoimmune disorders and responds to treatments like corticosteroids and tacrolimus, indicating an autoimmune component. Diagnosis is supported by trichoscopy and histopathology, although the latter often shows nonspecific results. Treatment requires long-term management with relapses being common, necessitating continuous medical care and preventive strategies.