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November 2009

Erosive Pustular Dermatosis of the Scalp Following Treatment With Topical Imiquimod for Actinic Keratosis

Arch Dermatol. 2009;145(11):1340-1341. doi:10.1001/archdermatol.2009.278

Erosive pustular dermatosis of the scalp (EPDS) is a rare chronic disease described first in 1977 by Burton1 and then in 1979 by Pye et al.2 It manifests as extensive pustular lesions, erosions, and crusting of the scalp in elderly individuals and leads to scarring alopecia. The cause remains unknown, although local trauma such as that caused by topical treatment of actinic keratosis with fluorouracil, 5%, tretinoin, surgery, cryotherapy, radiotherapy, and photodynamic therapy has been suggested as a trigger in actinically damaged or otherwise atrophic skin.3-5

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