Department of Specialized, Clinical, and Experimental Medicine, Division of Dermatology, University of Bologna, Bologna, Italy.
Department of Specialized, Clinical, and Experimental Medicine, Division of Dermatology, University of Bologna, Bologna, Italy.
J Am Acad Dermatol. 2017 Jun;76(6):1109-1114.e2. doi: 10.1016/j.jaad.2016.12.016. Epub 2017 Feb 14.
Erosive pustular dermatosis of the scalp is a chronic eruption that leads to scarring alopecia.
The clinical, dermoscopic, and histopathological features and the course of the disease in 20 patients were reviewed and compared with the reports in the literature.
Gender, age at diagnosis, age at onset, duration, topography, predisposing factors, concomitant diseases, trichoscopy, histology, treatment, and outcome were taken into consideration.
The mean age was 59.4 years. Androgenetic alopecia was present in 12 patients, 6 of whom showed actinic damage. Trauma was reported in 9 patients. Four patients were affected by autoimmune disorders. The vertex was the most common location. In all 20 patients trichoscopy showed an absence of follicular ostia with skin atrophy. Histopathology revealed 3 different features, depending on the disease duration. A reduction of inflammatory signs was observed in 14 patients treated with topical steroids and in all 3 patients treated with topical tacrolimus 0.1%.
The rarity of this disease is a limitation.
The relatively high number of patients allowed us to identify a better diagnostic approach, using trichoscopy, and a more effective therapeutic strategy, with high-potency steroids or tacrolimus, which should be considered as first-line treatment.
头皮侵蚀性脓疱性皮炎是一种导致瘢痕性脱发的慢性发作。
回顾和比较 20 例患者的临床、皮肤镜和组织病理学特征及疾病过程，并与文献报道进行比较。
考虑了性别、诊断时的年龄、发病年龄、病程、发病部位、诱发因素、伴随疾病、毛发镜检、组织学、治疗和预后。
平均年龄为 59.4 岁。12 例患者存在雄激素性脱发，其中 6 例存在光损伤。9 例患者有创伤史。4 例患者患有自身免疫性疾病。顶点是最常见的部位。在所有 20 例患者中，毛发镜检查均显示无毛囊口，伴有皮肤萎缩。组织病理学显示，根据疾病持续时间的不同，有 3 种不同的特征。14 例接受局部皮质类固醇治疗和 3 例接受局部他克莫司 0.1%治疗的患者炎症迹象减少。
这种疾病的罕见性是一个限制。
相对较多的患者使我们能够确定更好的诊断方法，使用毛发镜检，并制定更有效的治疗策略，使用高效皮质类固醇或他克莫司，应将其视为一线治疗。
