Abstract

Erosive pustular dermatosis (EPD) is a cutaneous inflammatory condition, characterized by chronically non-healing lesions with sterile pustules and hyperkeratotic crusted erosions. Although rare, severe cases have been referred by dermatologists to plastic surgeons for management. The aim of this paper was to describe the presentation and management of extensive EPD as well as a review of current literature on this rare condition. A case of presumed EPD of twelve years duration was presented. Extensive nature of the disease in a man with background history of chronic regional pain syndrome necessitated referral to plastic surgery service from dermatology. This challenging case involved a malnourished patient with extensive area of his upper limb skin affected by hyperkeratotic crusting erosions with surrounding atrophic changes and joint contractures. After initial debridement and tissue biopsy to exclude malignancy, patient was kept inpatient for daily dressing changes and topical potent corticosteroid application with support of anaesthetic service. Significant improvement of the condition was evident with serial photographic documentation records. Erosive pustular dermatosis, although rarely referred to plastic surgery, should be considered in the differential diagnosis of a non-healing wound. It should resolve readily with extended course of topical potent corticosteroid therapy.

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