Two Cases of Severe Erosive Pustular Dermatosis Mimicking Infection.

INTRODUCTION: Erosive pustular dermatosis of the scalp (EPDS) is a noninfectious inflammatory disorder characterized by pustules, erosions, ulcerations, and crusted erythematous plaques that is often associated with mechanical or chemical trauma. While its appearance may mimic infection, its etiology is thought to have an autoimmune component based on responsiveness to immunomodulators.

CASE REPORT: Herein, the authors present 2 cases of EPDS that were initially treated as primary infections. In both cases, the wounds did not respond to antimicrobial treatment and led to severe ulceration, exposing cranial bone. Both wounds improved with topical corticosteroid therapy.

CONCLUSIONS: These cases represent the importance of considering topical steroid treatment and a diagnosis of EPDS after debridement for purulent scalp ulcers.