Recurrence of erosive pustular dermatosis of the scalp following skin graft treatment

Introduction. Erosive pustular dermatosis of the scalp is a rare and chroni c dermatosis of unknown etiology with non specific histology and without ef fective treatment. It affects mostly old women. We have observed a go year- old male suffering from an erosive pustular dermatosis of the scalp followi ng application of 5 p. 100 fluorouracile cream (Efudex(R)) and his resistan ce to various treatments including skin graft. Observation. An 80 year-old man had been suffering, for many years from rec urrent episodes of pustules, erosions and crusts of the scalp, following tr eatment with 5 p. too fluorouracile cream for skin lesions diagnosed as act inic keratosis. Different topical and systemic treatments were tried withou t much improvement. A skin graft of the scalp lesional area was finally don e, showing a severe recurrence as a Koebner's reaction. Despite this recurr ence, we have observed an easier control with a topical mixture of steroid and antibiotic. Conclusion. This recurrence of erosive pustular dermatosis of the scalp fol lowing skin graft had never been previously observed before, showing that r emoving affected skin did not control the disease, suggesting that anti-inf lammatory agents probably originating from trauma persist.