Minoxidil

A 77-year-old woman with a history of type II diabetes and chronic obstructive pulmonary disease developed erosive pustular dermatosis of the scalp after using 5% topical minoxidil solution twice daily for androgenetic alopecia. Forty days after starting the treatment, she experienced scaly and itchy skin changes that progressed to pustules, erosions, and purulent discharge. Discontinuation of minoxidil and treatment with antibiotics and antifungals were ineffective. A biopsy confirmed the diagnosis of erosive pustular dermatosis. The patient's condition improved significantly after eight weeks of treatment with clobetasol, a topical steroid. Patch testing with minoxidil did not produce any reactions, suggesting that the alcohol in the solution might have been the triggering factor for the dermatosis.