Unusual localized crusting may be necrosis

My advice would be to not pick the crusts and return to your doctor. This patient should leave shampoo on the area for 15 minutes and then gently roll with the crusts using his finger once the crusts are water logged.  This should be repeated twice a day.  I am concerned that the central area may be necrosis.  I would like this patient to go back to his doctor for an examination when the crusts come off. If it is necrosis, he will need wound care. This particular area is the area that is most susceptible to necrosis.

Necrosis may be the cause of this unusual localized crusting.