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EROSIVE PUSTULAR DERMATOSIS (CHRONIC ATROPHIC DERMATOSIS OF THE SCALP AND EXTREMITIES)

Therapeutic Approach

Erosive pustular dermatosis (EPD) is a rarely reported noninfectious inflammatory disease. It can be caused or aggravated by certain medications and by photodynamic therapy. EPD occurs on the scalp or on the lower legs. It has a female predominance. EPD is more common in elderly but has been reported occasionally in children and adolescents. Choice of treatment is influenced by etiology, age of patients, and localization. If medications are suspected as triggers, these should be stopped or replaced whenever possible. Topical treatment with high potency corticosteroids is the treatment of choice in adults. In case of superinfection, these should be combined with topical antibiotics. We prefer fusidinic acid, since fusidinic acid is not used as a systemic drug in Germany. In other regions of the world oral antibiosis might be more preferable. Second-line treatment consists of oral antibiotics. We prefer tetracycline because of the anti-inflammatory activity. Further options are listed in the table. See Table 85-1.

Table 85-1Erosive Pustular Dermatosis Treatment Table

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