Dermoscopic Features of Erosive Pustular Dermatosis of the Scalp: A Comparative Multicentric Retrospective Study in Bald and Hairy Patients.

IF 1.9 4区医学 Q3 DERMATOLOGY

Clinical, Cosmetic and Investigational Dermatology Pub Date : 2025-03-20 eCollection Date: 2025-01-01 DOI:10.2147/CCID.S514416

Noemi Plozner, Enrico Zelin, Iris Zalaudek, Aimilios Lallas, Bianca Maria Piraccini, Michela Starace, Enzo Errichetti

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引用次数: 0

Abstract

Background: Erosive pustular dermatosis of the scalp (EPDS) is a rare inflammatory disorder primarily affecting elderly individuals with bald or hairy scalps. It is often misdiagnosed due to clinical overlap with other scalp conditions. Dermoscopy is an invaluable diagnostic tool for hair and scalp disorders, but its utility in EPDS remains underexplored. This study aims to identify dermoscopic features of EPDS and compare them with differential diagnoses to improve non-invasive recognition.

Materials and methods: A retrospective multicentric study was conducted across three Italian dermatological centers. Two cohorts, bald and hairy patients with histologically confirmed EPDS, were compared with controls diagnosed with conditions mimicking EPDS. Dermoscopic images at 10× magnification were analyzed by two independent evaluators using standardized criteria. Comparative analyses of dermoscopic features and interobserver agreement were performed, with statistical significance set at p<0.01.

Results: A total of 116 patients [53 bald patients (28 with EPDS and 25 controls) and 63 hairy patients (32 with EPDS and 31 controls)] were included in the study. Among EPDS bald patients, linear-curved vessels (unspecific distribution) (78.6%), orange structureless areas (diffuse) (46.4%), and yellow scales/crusts (focal) were the main findings, whereas focal yellow scales/crusts (84.4%) and the "peripheral horizontal hair" sign (84.4%) turned out to be the most common features in EPDS hairy patients. Comparative analysis revealed linear-curved vessels (p<0.001), orange structureless areas (diffuse) (p<0.001) and non-follicular pustules (p=0.005) to be distinctive features of EPDS in bald patients, while yellow scales/crusts (focal), non-follicular pustules and "peripheral horizontal hair" sign (horizontally arranged hair whose proximal part of the shaft is seen through a thinned epidermis at the edge of alopecic areas) were related (p<0.001) to EPDS in hairy patients. Interobserver agreement was excellent (Kappa=0.81-0.83).

Conclusion: Dermoscopy provides valuable diagnostic clues for EPDS, distinguishing it from other scalp disorders.

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来源期刊

Clinical, Cosmetic and Investigational Dermatology Medicine-Dermatology

CiteScore

2.80

自引率

4.30%

发文量

353

审稿时长

16 weeks

期刊介绍： Clinical, Cosmetic and Investigational Dermatology is an international, peer-reviewed, open access journal that focuses on the latest clinical and experimental research in all aspects of skin disease and cosmetic interventions. Normal and pathological processes in skin development and aging, their modification and treatment, as well as basic research into histology of dermal and dermal structures that provide clinical insights and potential treatment options are key topics for the journal. Patient satisfaction, preference, quality of life, compliance, persistence and their role in developing new management options to optimize outcomes for target conditions constitute major areas of interest. The journal is characterized by the rapid reporting of clinical studies, reviews and original research in skin research and skin care. All areas of dermatology will be covered; contributions will be welcomed from all clinicians and basic science researchers globally.