What are the causes of scalp pustules?

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Differential Diagnosis for Scalp Pustules

  • Single most likely diagnosis
    • Folliculitis: This is the most likely diagnosis due to the common occurrence of pustules on the scalp, which can be caused by bacterial or fungal infections, often related to shaving, tight hairstyles, or poor scalp hygiene.
  • Other Likely diagnoses
    • Acne keloidalis nuchae: A condition characterized by inflamed bumps and pustules on the scalp, particularly at the back of the neck, often associated with curly hair and tight hairstyles.
    • Seborrheic dermatitis: Although it typically presents with flakes and redness, seborrheic dermatitis can sometimes cause pustules on the scalp, especially in severe cases.
    • Psoriasis: Scalp psoriasis can cause pustules, along with other symptoms like redness, flakes, and thickened skin.
  • Do Not Miss (ddxs that may not be likely, but would be deadly if missed.)
    • Kerion: A severe form of tinea capitis (fungal infection of the scalp) that can cause pustules, along with other symptoms like hair loss, redness, and swelling. If left untreated, it can lead to scarring and permanent hair loss.
    • Bacterial infections (e.g., Staphylococcus aureus, Streptococcus pyogenes): These can cause pustules on the scalp and, if not treated promptly, can lead to more serious conditions like abscesses or sepsis.
  • Rare diagnoses
    • Pustular psoriasis: A rare form of psoriasis that can cause pustules on the scalp, often accompanied by other symptoms like redness, swelling, and fever.
    • Eosinophilic pustular folliculitis: A rare condition characterized by pustules on the scalp, often associated with eosinophilia (high levels of eosinophils in the blood) and can be related to immunosuppression or HIV infection.
    • Langerhans cell histiocytosis: A rare disorder that can cause pustules on the scalp, along with other symptoms like bone lesions, skin rashes, and organ dysfunction.

Professional Medical Disclaimer

This information is intended for healthcare professionals. Any medical decision-making should rely on clinical judgment and independently verified information. The content provided herein does not replace professional discretion and should be considered supplementary to established clinical guidelines. Healthcare providers should verify all information against primary literature and current practice standards before application in patient care. Dr.Oracle assumes no liability for clinical decisions based on this content.

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