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Facial Erosive Pustular Dermatosis After Cosmetic Resurfacing.

Julie E Mervak1, Stephanie D Gan1, Emily H Smith1

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Erosive pustular dermatosis (EPD) can occur on the face after cosmetic procedures. This rare condition presents as nonhealing facial erosions and requires anti-inflammatory treatments for management.

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Area of Science:

  • Dermatology
  • Cosmetic Procedures
  • Wound Healing

Background:

  • Erosive pustular dermatosis (EPD) is a rare, chronic skin condition typically affecting the scalp.
  • It is characterized by sterile pustules, erosions, and crusts, often on sun-damaged skin.
  • The exact etiology of EPD remains unknown, but trauma is considered an inciting factor.

Observation:

  • This case series describes three women who developed persistent facial erosions after undergoing cosmetic resurfacing.
  • Procedures included fully ablative carbon dioxide laser or medium-depth chemical peels.
  • The patients sought treatment for nonhealing facial wounds post-procedure.

Findings:

  • The three patients, all women aged 50s-60s, were diagnosed with facial EPD after excluding other conditions.
  • Histological findings were nonspecific.
  • Treatment involved a combination of topical/systemic therapies (corticosteroids, dapsone, isotretinoin, antibiotics) and watchful waiting.

Implications:

  • EPD can manifest on the face following cosmetic resurfacing procedures.
  • It is a diagnosis of exclusion for nonhealing facial wounds post-ablation.
  • Recognizing facial EPD is crucial given the increasing popularity of cosmetic procedures.