Erosive Pustular Dermatosis of the Scalp Following Topical Methylaminolaevulinate Photodynamic Therapy
March 2009
in “
Journal of the American Academy of Dermatology
”
TLDR A 93-year-old woman developed a rare scalp condition after therapy, which improved with steroids, not antibiotics.
A 93-year-old woman developed erosive pustular dermatosis of the scalp (EPDS) after undergoing topical methylaminolaevulinate photodynamic therapy (MAL-PDT) for actinic keratoses. Despite initial improvement, she experienced burning erosions and scarring alopecia, unresponsive to antibiotics. Histology showed a dense inflammatory infiltrate. Treatment with oral methylprednisolone and topical gentamycin-betamethasone cream led to marked improvement. EPDS, a rare condition in the elderly, often follows local trauma and responds to steroids rather than antibiotics. The case highlights the need to consider EPDS in patients with chronic inflammatory responses post-MAL-PDT.
