Erosive pustular dermatosis of the scalp: A neutrophilic folliculitis within the spectrum of neutrophilic dermatoses: A clinicopathologic study of 30 cases.

Background: It is general opinion that histopathology is nonspecific and of little value in diagnosing erosive pustular dermatosis of the scalp (EPDS).Objectives: Clinicopathologic correlation of erosive pustular dermatosis of the scalp.Methods: We reviewed the clinical and pathologic records of pat...

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Published in:Journal of the American Academy of Dermatology Vol. 81; no. 2; pp. 527 - 534
Main Authors: Tomasini, Carlo, Michelerio, Andrea
Format: research Journal Article
Published: Elsevier B.V. Aug2019
Online Access:View this record in EBSCOhost
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      dt: Aug2019
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      pub: Elsevier B.V.
      place: New York, New York
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        10.1016/j.jaad.2018.10.029
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        atl: Erosive pustular dermatosis of the scalp: A neutrophilic folliculitis within the spectrum of neutrophilic dermatoses: A clinicopathologic study of 30 cases.
      aug:
        au:
          Tomasini, Carlo
          Michelerio, Andrea
        affil: Department of Clinical-Surgical, Diagnostic, and Pediatric Science, Institute of Dermatology, Fondazione IRCCS Policlinico San Matteo, University of Pavia, Pavia, Italy
      sug:
        subj:
          Neutrophils Pathology
          Skin Diseases Pathology
          Skin Diseases Diagnosis
          Folliculitis Pathology
          Diagnostic Errors
          Time Factors
          Aged, 80 and Over
          Female
          Middle Age
          Aged
          Alopecia Pathology
          Folliculitis Etiology
          Male
          Skin Diseases Etiology
          Human
          Aged, 80 & over
          Middle Aged: 45-64 years
          Aged: 65+ years
          Female
          Male
      ab: Background: It is general opinion that histopathology is nonspecific and of little value in diagnosing erosive pustular dermatosis of the scalp (EPDS).Objectives: Clinicopathologic correlation of erosive pustular dermatosis of the scalp.Methods: We reviewed the clinical and pathologic records of patients with a clinicopathologic diagnosis of EPDS between 2011 and 2016 at the Dermatopathology Unit of Turin University.Results: Thirty elderly patients with EPDS were identified (22 men and 8 women). Androgenetic alopecia was present in 19 of 30 patients. Triggering factors included mechanical trauma in 10 of 30 cases, surgical procedures in 4 of 30 cases, and herpes zoster in 1 of 30 cases. Three patients were affected by autoimmune disorders. The vertex was the most common location. Disease presentation varied markedly from tiny, erosive, scaly lesions to crusted and hemorrhagic plaques, mimicking pustular pyoderma gangrenosum. The pathologic changes differed according to lesion type and disease duration. Interestingly, a spongiotic and suppurative infundibulo-folliculitis was observed in 8 of 30 cases.Limitations: This was a retrospective study.Conclusions: We believe that the primary lesion of erosive pustular dermatosis of the scalp is a spongiotic, pustular superficial folliculitis. The clinicopathologic similarities with other neutrophilic dermatoses, such as pustular pyoderma gangrenosum, suggest this condition should be included in this spectrum, where pathergy plays a pathogenetic role.
      pubtype: Academic Journal
      doctype:
        research
        Journal Article
      ougenre: Article
    language: English
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