Tchernev Georgi, Kordeva Simona, Batashki Ilia, Batashki Atanas, Kirilova Heily, Stavrov Konstantin
Onkoderma-Clinic for Dermatology, Venereology and Dermatologic Surgery, Sofia, Bulgaria.
Department of Dermatology and Venereology, Medical Institute of Ministry of Interior, Sofia, Bulgaria.
Dermatol Reports. 2022 Jul 12;15(1):9556. doi: 10.4081/dr.2022.9556. eCollection 2023 Mar 7.
Erosive pustular dermatosis of the scalp (EPD) is a rare condition that affects predominantly the adult population and occurs on a previously photo-damaged bald scalp. The physical examination is presented with large erythematous, erosive and crusted patches with granulation on an atrophic skin. The problem in patients with erosive pustular dermatosis of the scalp arises from the non-specific clinical and histopathological findings, which can be misleading. Biopsy followed by careful histopathological verification is mandatory, although the finding is nonspecific. The histopathology findings are characterized by superficial erosions with mild neutrophil infiltrate, mainly intravascular and focally with neutrophil exocytosis; focal parakeratosis, smoothed rete ridges without pronounced interface changes; pronounced lymphoplasmacytic infiltrate with focal distribution in the dermis and giant cell reaction with the formation of a "foreign body" granuloma.. We report a 58-year-old male patient with a 1-year-old lesion, suspected for skin cancer, later diagnosed with EPDS, which was successfully treated with topical clobetasol proprionate after 3-5weeks.
头皮糜烂性脓疱性皮病（EPD）是一种罕见疾病，主要影响成年人，发生于先前受光损伤的秃头皮上。体格检查可见萎缩皮肤上有大片红斑、糜烂及结痂斑块伴肉芽组织。头皮糜烂性脓疱性皮病患者的问题源于非特异性的临床和组织病理学表现，可能会产生误导。尽管结果是非特异性的，但必须进行活检并随后进行仔细的组织病理学验证。组织病理学表现为浅表糜烂伴轻度中性粒细胞浸润，主要为血管内浸润且局灶性有中性粒细胞外渗；局灶性角化不全， rete嵴变平，无明显界面改变；真皮内有明显的淋巴细胞和浆细胞浸润，呈局灶性分布，并有巨细胞反应形成“异物”肉芽肿。我们报告一例58岁男性患者，有1年病损，曾怀疑为皮肤癌，后来诊断为EPDS，经3 - 5周外用丙酸氯倍他索成功治疗。
