Author: Dr Ian Coulson, Consultant Dermatologist and Editor-in-Chief, 2023.
Edited by the DermNet content department
This 80-year-old man has had large crusted lesions over his bald anterior scalp for some months. A large scab has been removed revealing the appearance seen in the photograph.
There are superficial erosions over the scalp surmounted with thick pus. There are also several actinic keratoses.
The picture is typical of erosive pustular dermatosis of the scalp. It is seen mostly in older bald men with sun damaged scalps.
It has also been reported on the lower leg, a heavily sun exposed site particularly in women.
Removing the overlying crusts and using a potent topical steroid and antibiotic combination cream can be very gratifying. Areas that do not heal should be re-evaluated and possibly biopsied to exclude squamous cell carcinoma.
