This form of hair loss occurs almost exclusively in men of African descent, but can occasionally occur in women. It begins as small firm bumps in the back of the neck Latin nuchae) or elsewhere, which over time can become larger and more confluent. In severe cases it can result in a large keloid-appearing plaque. Mechanical trauma from haircuts or clippers may play a role in initiating this condition, however it is still considered a primary scarring alopecia, often co-existent with CCCA (central centrifugal cicatricial alopecia).
Erosive Pustular Dermatosis
Erosive pustular dermatosis of the scalp is a relatively uncommon condition and is more likely to affect older individuals than younger. Patients with a history of extensive sun damage or history of other trauma to the scalp seen to be more likely to develop this condition. Individuals with the condition often develop crusted erosions on the scalp some of which have pus. The crusts can sometimes be lifted from the scalp to reveal the erosions.
Symptoms and Causes
This is a fairly new condition first described in the last 20-30 years. It presents with chronic moist, crusting, or oozing erosions over the top of the scalp. The lesions usually develop in areas that have been sun damaged (with actinic keratosis or skin cancer) followed by treatment such as Mohs surgery, use of skin cancer creams like 5-fluorouracil or imiquimod cream, or in the context of other systemic cancer fighting treatments such as capecitabine or bevacizumab. Interestingly, it has also been reported in the context of a glued-on hairpiece, as a result of contact allergy from the hair dye.
Missouri Hair Institute
556 Rush Creek Pkwy, Suite B
Liberty, MO 64068