Erosive pustular dermatosis: new description of a possible cause of the non-healing burn wound.

INTRODUCTION: Erosive pustular dermatosis (EPD) is a cutaneous condition, characterised by sterile pustular lesions, erosions and crusting. Extensive or infected disease may result in scarring. EPD has never been reported following burn. The aim of this study was to describe the presentation and management of EPD complicating burns wounds.

METHODS: A consecutive series of EPD cases secondary to burn.

RESULTS: Six cases were identified. In each case, erosive lesions and crusts were located at the site of burn or at the site of split skin grafting after tangential burn excision. All cases presented as failure to heal or repeated wound breakdown, despite standard burn wound management. Pain was a significant feature in all cases. Microbiological cultures demonstrated either benign colonising bacteria or no pathogens. Time to EPD diagnosis by the interdisciplinary team was 126 ± 27 days (mean ± SEM). Topical therapy with short course, potent corticosteroids resulted in clinical remission in 15 ± 2 days (mean ± SEM) without clinical relapses after 15 ± 4 months (mean ± SEM).

CONCLUSION: EPD may occur following burns. EPD should be considered in the differential diagnosis of a non-healing burn wound and resolves readily with topical potent corticosteroid therapy.