Pityriasis amiantacea in erosive pustular dermatosis of the scalp: A report of three cases

Erosive pustular dermatosis is an uncommon chronic inflammatory condition of the scalp characterized by crusted, erosive plaques and subsequent cicatricial alopecia. Management of erosive pustular dermatosis remains challenging, and various treatments have been described in the literature with inconsistent results. Herein, we report three cases of erosive pustular dermatosis with a pityriasis amiantacea-like presentation in the context of poor scalp hygiene. All patients presented with thick adherent crusts on the scalp that were refractory to multiple therapies. Significant clinical improvement was achieved by addressing scalp hygiene through regular cleansing and the use of dilute sodium hypochlorite compresses, in combination with topical corticosteroids as well as systemic and topical antibiotics. Our findings highlight the importance of addressing scalp hygiene to ameliorate treatment outcomes and minimize the risk of recurrence in patients with erosive pustular dermatosis, especially those with a pityriasis amiantacea-like presentation.