头皮糜烂性脓疱性皮病

报告1例头皮糜烂性脓疱性皮病.患者女,50岁.因头皮反复出现脓疱、糜烂、破溃、结痂8年就诊.实验窜检杳、皮损分泌物细菌和真菌学检查及皮损组织病理检查均无特殊异常.抗生素治疗无效,口服或外用糖皮质激素治疗后皮损明显好转.符合头皮糜烂性脓疱性皮病的诊断.     

头皮糜烂性脓疱性皮病1例

报告1例头皮糜烂性脓疱性皮病.患者女,82岁,因右侧头皮颞部反复出现红斑、脓疱、糜烂、结痂3个月就诊.皮肤科检查:右侧头皮颞部见大片红斑、糜烂、结痂,中间部分毛发脱落,皮肤轻度萎缩,浅表疤痕形成.皮损组织病理示:浅表糜烂结痂,表皮不规则增生,部分表皮轻度萎缩,真皮浅层可见以淋巴、组织细胞、浆细胞及少量中性粒细胞为主的混...     

头皮糜烂性脓疱性皮病一例

患者,女,50岁.头皮红斑、脓疱伴疼痛6个月.皮肤科查体:头皮弥漫性分布紫红色浸润性斑片,其上见脓疱,局部见斑片状脱发区.实验室检查:取脓疱疱液多次行细菌及真菌培养均阴性.组织病理:表皮角化过度伴角化不全;真皮浅中层弥漫性淋巴细胞、浆细胞、中性粒细胞浸润.抗生素治疗效果不佳,口服糖皮质激素及外用他克莫司治疗后有效.诊断...     

争性全身发疹性脓疱病

急性全身发疹性脓疱病的临床特点为起病急骤以小脓疱为主的多形性皮疹，伴高热，畏寒白细胞增高，血沉加快等，病理表现为角层下脓疱，脓疱周围棘层海绵形成以及真皮反应性血管炎，常由药物、感染和其它因素引起，急性全身发疹性脓疱病需与感染性和以脓疱性银悄病为代表的无菌性脓疱性皮肤病进行鉴别，本病预后好，有自限性，停止使用可疑的诱发药物加一一般对症处理后，皮诊即在短期内消退。     

头皮糜烂性脓疱性皮病

正患者女,54岁。主诉:头皮红斑及脓疱3年,加重伴脱发3个月。现病史:患者3年前无明显诱因于头皮出现两个蚕豆大红斑,表面有散在针尖至米粒大脓疱,孤立不融合,易糜烂,疼痛明显,症状反复发作,对症治疗缓解不明显。3个月前头皮再次出现皮损,面积逐渐扩大,并出现脱发,外院行真菌镜检、真菌及细菌培养均阴性,组织病理检查示感染性肉芽肿,予伊曲康唑0.2 g口服,每日2次,克拉霉素0.5 g每日1次口服,碘伏外用,试验性治疗4周后皮损无改善,遂停药。发病前及病程中无宠物及海产     

角层下脓疱性皮病1例

报告1例角层下脓疱性皮病。患者,女,36岁。反复躯干及双上肢脓疱13年。皮肤科检查：颈周、双侧腋下、胸腹部及双上肢近端屈侧见散在或密集粟粒大的脓疱,疱内上部液体澄清、下部混浊呈半月状,部分融合成片,形成脓湖,部分上覆黄色脓痂,周围红晕,环形或匐行性分布。皮损组织病理检查：角质层及表皮浅层可见灶状中性粒细胞聚积,微脓肿形成,上皮脚增生延长,真皮浅层小血管周围见多量淋巴细胞浸润。     

急性泛发性发疹性脓疱性皮病1例

报告1例急性泛发性发疹性脓疱病。患者女，75岁，躯干、四肢起红斑，部分融合成大片，其上密集分布粟粒至米粒大的脓疱，部分脓疱互相融合成“脓湖”，右下肢部分片状脱屑。组织病理示角层下脓疱。患者在发疹前2h使用过青霉素等药物。     

头皮糜烂性脓疱性皮病一例

患者男,89岁。因头皮反复出现脓疱、糜烂、结痂、瘢痕4年余,于2014年3月来我科就诊。患者4年余前无明显诱因右侧头顶部头皮出现数个脓疱、结痂,伴轻微痒、痛、灼热感,就诊于外院,疑诊“带状疱疹”,予抗病毒药物治疗未见明显缓解,皮疹逐渐蔓延至双侧头皮,脓疱渐破溃、干燥结痂,痂脱落后遗留萎缩性瘢痕,无头发生长。此后头皮常有瘙痒及灼热感,晒太阳后加重,皮疹亦间断出现,曾外用莫匹罗星软膏无效,外用神农百草膏（成分不详）后,上述症状和皮疹可缓解,但停药后又复发。1个月前皮疹再次出现,为进一步诊治来我科就诊。患者既往有糖尿病史10余年,平素口服阿卡波糖、格列美脲控制血糖,血糖控制尚可……     

角层下脓疱性皮病

1 病例资料 病史：患者女，12岁。以颈周、躯干、外阴部脓疱伴发热反复发作1年入笔者所在医院。1年前，患者每周吃海鲜后颈部出现数个散在粟粒大小的脓疱，无自觉症状，外用复方达克宁、丁酸氢化可的松（尤卓尔）治疗可消退。8个月前，食是事颈部再次出现小脓疱，数量较前增多，部分副合成片，并伴发热，体温不详。     

DDS引起急性泛发性发疹性脓疱性皮病1例

临床资料　患者男性 ,17岁 ,1988年无明显诱因左手大拇指和无名指指甲出现红斑、脓疱 ,皮损迁延不愈 ,后受累指甲脱落。曾在外院多次诊治 ,1994年 6月到本院门诊就诊 ,诊断为“连续性肢端皮炎” ,给予ＤＤＳ、雷公藤总甙口服 ,3天后全身出现散在红斑及针头大小脓疱伴高热 ,血常规 :ＷＢＣ11 4× 10 9/Ｌ ,Ｎ 0 78,Ｌ 0 2 2。门诊以“脓疱性银屑病 ,连续性肢端皮炎”收入院。入院查 :Ｔ 40℃ ,Ｐ 112次 /分 ,ＢＰ 13/8Ｋｐａ ,急性病容 ,系统检查无异常发现。皮肤科情况 :全身散在分布红斑 ,其上有粟粒大小脓疱 ,左大拇指、左无名指指甲缺…     

Erosive pustular dermatosis of the scalp successfully treated with oral prednisone and topical tacrolimus

Erosive pustular dermatosis of the scalp is a rare inflammatory disorder of the scalp, affecting elderly patients after local trauma and leading to scarring or cicatricial alopecia. Case Report: An elderly female patient complained of painful pustules on the parietal region bilaterally with progressive enlargement and ulceration. A biopsy suggested erosive pustular dermatosis of the scalp and the patient was treated with prednisone 40 mg/day and 0.1% topical tacrolimus. After 10 weeks complete closure of the eroded areas was observed and a stable scarring alopecia developed.     

Erosive pustular dermatosis of the scalp

We report six patients with a previously undescribed but characteristic pustular dermatosis confined to the scalp. All the patients were elderly women who developed chronic, extensive, pustular, crusted and occasionally eroded lesions of the scalp which produced scarring alopecia. Investigations were essentially negative and skin biopsies showed only non-specific changes of atrophy and chronic inflammation, sometimes with increased plasma cells in the infiltrate. The condition did not respond to antibiotics, but was suppressed by potent topical steroids.     

Erosive pustular dermatosis of the scalp following surgery

A 53-year-old woman presented with erosive pustular dermatosis of the scalp 6 weeks after a bifrontal skin flap and right frontal craniotomy had been performed for removal of a suprasellar meningioma. Although some authors consider that acute local trauma is a precipitating factor for this condition,^1–5 we believe that this is the first reported case following a neurosurgical procedure.     

Erosive pustular dermatosis of the scalp after perinatal scalp injury

We report four infants born with necrotic caput succedaneum that led to a scarring alopecia with ongoing inflammation and persistent scale-crust. These lesions did not significantly improve with topical or oral antibiotics, but did respond somewhat to topical corticosteroids. Alopecia with chronic erosive scale-crust and a moderate response to topical corticosteroids are findings consistent with a diagnosis of erosive pustular dermatosis of the scalp.     

Erosive pustular dermatosis of the scalp: causes and treatments

Erosive pustular dermatosis of the scalp is a rare condition which primarily affects older women after local trauma and has historically been treated with topical steroids. As it is a rare entity and resembles other dermatologic conditions, it may easily be misdiagnosed. Identifying the causes and evaluating the efficacy of treatments of erosive pustular dermatosis of the scalp (EPDS) is of great importance to both avoid misdiagnosis and ensure optimal treatment of this rare condition. There are numerous causes. In addition to surgeries and physical injuries, topical and procedural treatments for actinic keratoses and androgenetic alopecia can trigger the development of lesions. There are also documented associations with several autoimmune and systemic conditions. Besides corticosteroids, topical tacrolimus and photodynamic therapy were the most commonly used treatments for EPDS. They were effective with few recurrences and adverse effects. Other successful treatment options were topical dapsone, silicone gels, calcipotriol, acitretin, and isotretinoin. Oral dapsone can be used in cases of disseminated disease. Zinc sulfate should be considered with low‐serum zinc levels. While cyclosporine was effective, there were adverse effects that may limit its use. It is important for dermatologists to be aware of the wide array of potential causes of erosive pustular dermatosis and include it on their differential. Additionally, although high‐potency topical steroids have been historically used as the first‐line treatment, there are many other effective treatments that may avoid recurrence and skin atrophy, particularly in the elderly population.