Facial Erosive Pustular Dermatosis After Cosmetic Resurfacing 激光技术镭射磨皮导致面部糜烂性脓疱性皮肤病
Importance Erosive pustular dermatosis (EPD) is a rare condition that typically affects actinically damaged skin of the scalp. Characterized by sterile pustules, erosions, and crusts, EPD is difficult to treat and heals slowly. The exact cause of EPD is unknown, although trauma is an inciting factor.
Objective To describe 3 women who presented with prolonged facial erosions after cosmetic resurfacing procedures, specifically fully ablative carbon dioxide laser or medium-depth chemical peel.
Design, Setting, and Participants This case series describes the clinical features, histopathological findings, laboratory results, and treatment of 3 patients with an ultimate diagnosis most consistent with facial EPD. Patients were evaluated between September 10, 2010, and May 6, 2016, in a dermatology clinic in an academic medical center. The patients were 3 women seeking diagnostic evaluation and therapeutic options for nonhealing facial erosions occurring after ablative procedures (carbon dioxide laser resurfacing or Jessner solution/trichloroacetic acid chemical peel).
Main Outcomes and Measures Histologic examination and wound culture from initial presentation as well as clinical follow-up documenting improvement with therapeutic interventions.
Results All 3 patients were women in their 50s or 60s for whom EPD was deemed to be the best diagnosis, after infection, immunobullous disorders, and other pustular dermatoses were considered. Histologic features were nonspecific. Treatment included a combination of topical and systemic therapies, such as corticosteroids, dapsone, isotretinoin, and/or antibiotics. Watchful waiting (tincture of time) appeared to be central to the healing process.
Conclusions and Relevance After cosmetic resurfacing, patients may develop EPD isolated to the face. As a diagnosis of exclusion that should be considered in patients who have nonhealing wounds following ablative procedures, EPD is challenging to treat and may require the use of anti-inflammatory agents. Recognizing this condition is important, especially as cosmetic procedures become more widespread.
糜烂性脓疱性皮肤病（EPD）是一种罕见的疾病，通常会影响光化学损伤的头皮皮肤。 EPD的特点是无菌脓疱，糜烂和结痂，难以治疗且愈合缓慢。尽管创伤是诱发因素，但EPD的确切病因尚不清楚。
本文献描述了3例女性在二氧化碳激光整容或中等深度化学剥脱换肤美容手术后出现长时间的面部皮肤糜烂。
该病例系列描述了3例患者的临床特征、组织病理学发现、实验室结果和治疗与糜烂性脓疱性皮肤病相一致，并且最终诊断为糜烂性脓疱性皮肤病（EPD）。三位患者于2010年9月10日至2016年5月6日之间，在学术医学中心的皮肤科对患者进行评估。患者为3位女性，他们寻求消融手术（二氧化碳激光换肤美容或Jessner溶液/三氯乙酸化学剥离换肤美容）后出现长期不愈合的面部糜烂而前来本中心诊断评估和治疗。
