Erosive Pustular Dermatosis of the Scalp Successfully Treated with Oral Prednisone and Topical Tacrolimus

Erosive pustular dermatosis of the scalp (EPDS) is a rare inflammatory condition primarily affecting elderly individuals, often following local trauma, and leading to scarring alopecia. This case report detailed a 68-year-old woman with painful pustules and progressive scalp erosion, initially misdiagnosed and unsuccessfully treated with antibiotics and antivirals. A biopsy confirmed EPDS, and treatment with oral prednisone (40 mg/day) and 0.1% topical tacrolimus resulted in complete healing of the eroded areas after 10 weeks, though it left permanent scarring alopecia. The combination therapy allowed for tapering of prednisone, highlighting the effectiveness of this treatment approach for EPDS.