Erosive Pustular Dermatosis of the Scalp Following Hair Transplantation: A Rare Complication

TL;DR

A 31-year-old man developed a rare skin condition called EPDS after a hair transplant, showing that surgical trauma can trigger it in younger individuals.

Contribution

This case report highlights that surgical trauma from hair transplantation can trigger EPDS in younger individuals without typical risk factors.

Findings

EPDS was diagnosed in a 31-year-old male following follicular unit extraction (FUE).

High-potency topical corticosteroids were effective in treating the condition.

Surgical trauma may act as a pathergy trigger for EPDS in younger individuals.

Abstract

Erosive pustular dermatosis of the scalp (EPDS) is a rare inflammatory condition characterized by sterile pustules, crusts, and skin atrophy, leading to scarring alopecia. While typically affecting the elderly, this report discusses a rare instance in a 31-year-old male who developed EPDS following follicular unit extraction (FUE) for androgenetic alopecia. The diagnosis was confirmed through clinical, dermoscopic, and histopathological examination. Initial treatment with topical steroids showed temporary improvement, but the condition relapsed upon tapering. High-potency topical corticosteroids were ultimately effective. This case underscores the importance of early recognition of EPDS, highlighting the value of clinical, trichoscopic, and histopathologic examination in improving patient outcomes. It also expands the understanding of EPDS by suggesting that surgical trauma may trigger pathergy, potentially initiating the condition in younger individuals without typical risk factors. Given the increasing popularity of hair transplantation, clinicians must remain vigilant about rare complications like EPDS to ensure prompt diagnosis and prevent irreversible alopecia.

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