Erosive Pustular Dermatosis of the Scalp

Clinicopathological Correlation Leading to a Definition of Diagnostic Criteria

Robin Reschke, MD; Sonja Grunewald, MD; Uwe Paasch, MD; Marco Averbeck, MD; Jan C. Simon, MD; Tino Wetzig, MD


Wounds. 2021;33(6):143-146. 

In This Article

Materials and Methods

Patient Selection

Data were retrospectively collected from patients (age range, 73–90 years) who were treated for EPDS at the University of Leipzig Medical Center and Asklepios Medical Center, Weißenfels, Germany. Initially, patients were admitted for suspected squamous cell cancers of the scalp. All lesions were biopsied for histopathological evaluation.

Clinical and Histopathological Analyses

Each patient's clinical course and background were obtained from medical records. All tissue biopsies were taken from the center of the lesions, then screening was conducted for tumors and characteristic cellular patterns in hematoxylin-eosin staining.

Diagnostic Criteria

Clinical criteria consisted of the following: chronic, poorly healing lesions on the scalp (purulent crusts overlying shiny granulation tissue); elderly patients; external injury to the skin most frequently damaged by actinic keratoses (eg, PDT, cryotherapy, imiquimod, surgery); skin in marginal areas easily detachable by forceps; and excellent response to topical steroids. The histopathological criterion was prominent dermal infiltrates of plasma cells and lymphocytes in a perivascular pattern or spread over the entire dermis.