LAUSR

Hair-styling procedures can produce chemical and/or thermal burns to the scalp. We describe a case of erosive pustular dermatosis (EPD) of the scalp related to a burn caused by a hair-bleaching procedure, which is the first such case reported, to our knowledge. A 25-year-old woman presented with an 18-month history of superficial ulceration on her scalp after a hair highlighting procedure at a hairdressing salon. The patient had undergone highlighting and dyeing of her hair on several previous occasions without any problem, and her medical history was not relevant. During the bleaching procedure, each lock of hair had been coated with the bleaching product containing alkaline persulfates, then wrapped with aluminum foil and heated with a hairdryer to speed up the process. A few minutes after the end of the process, the patient experienced a stinging and burning pain on her scalp localized to the region, where the chemical had been applied and heated. During the next few days, an oval-shaped ulcer developed on the vertex of the patient’s scalp, which did not heal in spite of daily hydrocellular dressings, topical fusidic acid cream and amoxicillin treatment for several weeks as prescribed by a general practitioner. On physical examination, ulcerations with peripheral erosions and crusts were seen on the vertex of the patient’s scalp (Fig. 1). Surface swabs were taken, and microbiological studies were all negative other than a heavy growth of methicillin-sensitive Staphylococcus aureus.