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.

laser feature

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。




Mervak JE, Gan SD, Smith EH, Wang F. Facial Erosive Pustular Dermatosis After Cosmetic Resurfacing. JAMA Dermatol. 2017;153(10):1021–1025. doi:10.1001/jamadermatol.2017.2880