INTRODUCTION
Erosive pustular dermatosis of the scalp (EPDS) is a rare chronic inflammatory condition manifesting as sterile pustules, hyperkeratotic plaques, and crusted erosions on the scalp that typically cause scarring alopecia.1 EPDS primarily affects older individuals with sun-damaged skin, and local trauma is a common inciting factor; however, the exact pathophysiology remains unknown.1,2 Currently, no treatment guidelines exist for EPDS. This review explores common management strategies and proposes an updated EPDS treatment algorithm (Figure 1).
Topical Corticosteroids
Topical corticosteroids (TCSs) are the most common EPDS treatment, and clobetasol is most frequently utilized. In the largest EPDS case series, among 30 patients using clobetasol propionate 0.05% ointment (CPO) nightly, 27 experienced significant improvement within 4 weeks.3 Treatment was reduced to twice weekly for 3 months before cessation; however, all patients experienced post-cessation relapses, requiring retreatment followed by twice-weekly clobetasol maintenance therapy (MT). With MT, most patients showed good disease control at 3-year follow-up.3 In another 17-patient case
Topical Corticosteroids
Topical corticosteroids (TCSs) are the most common EPDS treatment, and clobetasol is most frequently utilized. In the largest EPDS case series, among 30 patients using clobetasol propionate 0.05% ointment (CPO) nightly, 27 experienced significant improvement within 4 weeks.3 Treatment was reduced to twice weekly for 3 months before cessation; however, all patients experienced post-cessation relapses, requiring retreatment followed by twice-weekly clobetasol maintenance therapy (MT). With MT, most patients showed good disease control at 3-year follow-up.3 In another 17-patient case
