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Erosive pustular dermatosis of the scalp after contact dermatitis from a prosthetic hair piece.pdf
CASE REPORT
Erosive pustular dermatosis of the scalp after contact dermatitis from a prosthetic hair piece
Jay S. Herbst, MD, FAAD, and Alexander T. Herbst, BS Port Charlotte and Tallahassee, Florida
Key words: alopecia; contact dermatitis; erosive pustular dermatosis of the scalp; hair loss; scalp; tacrolimus.
INTRODUCTION Erosive pustular dermatosis of the scalp (EPDS) is
an uncommon condition that is reported after local injuries including burns, cryotherapy, radiation therapy, photodynamic therapy, skin grafts, and hair transplantation as well as topical medication treatments including retinoids, imiquimod, and 5?uorouracil.1-6 We present a case of erosive pustular dermatosis of the scalp developing after contact dermatitis induced by a glued-on hair piece. Although skin trauma, including irritant reactions from topical medications, is documented to precipitate this condition, to the best of our knowledge, contact dermatitis from cosmetic application of hair pieces has not previously been reported as a triggering factor.
CASE REPORT A 58-year-old white woman presented with a
pruritic eruption on her scalp, which began after having glued-on hair pieces applied by a hair restoration center. She reported her preceding hair loss as diffuse ‘‘thinning,’’ progressing over years, without ?aking, burning, or itching. She was not aware of a similar family history. At the hair restoration center, the process of shaving the central portion of her scalp, applying glue, and attaching a hair piece was repeated 3 times within a 3-month period. A pruritic rash began several days after the application of the ?rst hair piece. Subsequently, 2 more hair pieces were applied despite worsening of the eruption. The ?nal hair piece was then removed and not reapplied. Physical examination found discrete and con?uent pink plaques with crusting and excoriations, closely tracking the U-shaped
Abbreviation used:
EPDS: erosive pustular dermatosis of the scalp
pro?le of the adhesive portion of
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