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Recurrent Scalp Erosion in an Elderly Woman
The 89-year-old has used topical mupirocin twice daily for several weeks without improvement. Examine the images. What's your diagnosis?
Figure 1. Erosion on right frontal scalp area. (Click)
Figure 2. Crusting and purulent exudate is seen. (Click)
An 89-year-old woman is seen in follow-up for a new erosion on the right frontal scalp area (Figure 1). She has a history of biopsy-proven actinic keratosis (AK) on her scalp that was treated with topical 5-fluorouracil cream. She uses a washcloth to scrub the area.
On examination, she is very fair skinned with extensive photo damage. The skin of the scalp is very thin. She had used topical mupirocin twice a day for several weeks without improvement and now there is crusting and purulent exudate overlying the area (Figure 2). Skin cultures taken show normal flora. No other pathology or adenopathy are noted.
What is your diagnosis?
A. Dissecting cellulitis of the scalp
B. Eosinophilic pustular folliculitis
C. Erosive pustular dermatosis of the scalp
D. Chronic bacterial folliculitis
E. Chronic actinic damage with secondary infection
For answer, case resolution, and discussion, please click here.
Atopic Dermatitis: The Pipeline and Clinical Approaches That Could Transform the Standard of Care
September 24th 2025Patient Care tapped the rich trove of research and expert perspectives from the Revolutionizing Atopic Dermatitis 2025 conference to create a snapshot of the AD care of the future.
