QHow do you manage patients with erosive pustular dermatosis?

Richard Winkelmann, DO

Richard Winkelmann, DO

Director for Dermatology and Mohs Surgery
Optum Care
Los Angeles, CA

Erosive pustular dermatosis is a chronic inflammatory condition occurring typically in older men with androgenetic alopecia in response to surgery or localized trauma characterized by crusted plaques on the top of the scalp.1 The goals of treatment are to reduce inflammation, promote healing of erosions, and halt the progression of scarring hair loss. The cases typically respond within several months, but patients should be educated that some cases are prolonged and can be refractory. Treatment requires mid to high-potency topical steroids alone or in combination with topical calcipotriene inhibitors. For prolonged disease, success has been reported with systemic steroids and photodynamic therapy.2 Erosive pustular dermatosis typically occurs in areas of actinic damage, therefore follow-up for the detection of recurrence of the development of skin cancer is strongly recommended.


  1. Starace et al. J Am Acad Dermatol 2017
  2. Junejo et al. Br J Dermatol 2021