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Scalp ulcers - differential diagnoses that should be sought!
Eran Shavit1, Mona Alkallabi1, Afsaneh Alavi1
1Division of Dermatology, Department of Medicine, Women's College Hospital, University of Toronto, Toronto, ON, Canada.
International Journal of Dermatology
|July 4, 2019
Summary
Scalp ulcers are rare but often indicate malignancy. Early skin biopsy is crucial for accurate diagnosis and to prevent complications from these concerning lesions.
Area of Science:
- Dermatology
- Oncology
- Pathology
Background:
- Scalp ulceration presents a diagnostic challenge with diverse potential causes, including infections, inflammatory conditions, and malignancies.
- Understanding the etiology of scalp ulcers is essential for effective clinical management.
Purpose of the Study:
- To investigate the underlying causes of scalp ulcers referred to a tertiary wound healing clinic.
- To propose a classification system for scalp ulcerations based on identified etiologies.
Main Methods:
- A retrospective analysis of 15 patients with scalp ulcers treated at an academic tertiary wound healing clinic from January 2015 to June 2018.
- A comprehensive literature review was performed to identify reported causes of scalp ulceration.
Main Results:
- Histological examination of skin biopsies revealed a high malignancy rate of 73% (11 out of 15 patients) among those with atypical scalp ulcers.
- The literature review identified 41 relevant case reports after screening 237 articles.
Conclusions:
- Scalp ulcers, though uncommon, frequently signify underlying malignancy, necessitating prompt clinical suspicion.
- Early diagnostic biopsy is critical for accurate identification of the cause and to mitigate potential complications associated with scalp ulceration.
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