A 46-year-old woman presented with a history of pruritus and crusting of the scalp. She also reported a 3-month history of painful axillary ulcerations and a 2-week history of painful genital ulcerations. Physical examination revealed diffuse yellowish crusting with underlying erosions involving the entire scalp and extending beyond the hairline onto the forehead (Figure 1). Bilateral ulcerations with surrounding erythema and a small amount of yellowish drainage (Figure 2) were present on her axillae. Erosions involving the labia majora were seen extending into the inguinal creases bilaterally. A fungal culture from the scalp and a viral culture from the genitalia were negative.
Hoang MP, Owen SA, Haisley-Royster C, Allen MH, Shea CR, Selim MA. Papular Eruption of the Scalp Accompanied by Axillary and Vulvar Ulcerations. Arch Dermatol. 2001;137(9):1241-1246. doi: