Hair and Scalp Treatments by Unknown

Author:Unknown
Language: eng
Format: epub
ISBN: 9783030215552
Publisher: Springer International Publishing

Diagnostic Procedures and Labs Required Before Starting Treatment

SP diagnosis is clinical, showing erythema, scaling, and itching. The scales can be silver white or yellow, and hair loss is very common (Fig. 13.1). Do not forget to look for other psoriasis features on skin and nails. Scalp dermoscopy is very useful to confirm the diagnosis, showing interfollicular and perifollicular white-yellow scales (Fig. 13.2), vascular red dots and globules (Fig. 13.3), twisted capillary loops (Fig. 13.4), and glomerular vessels. These features are not limited to the affected areas of the scalp; they are also present in the apparently noninvolved scalp. The number of twisted capillary loops correlates with disease severity. In seborrheic dermatitis (SD), dermoscopy shows arborizing vessels but not the twisted loops. Occasionally, a skin biopsy is performed to rule out other conditions. Histologic findings include epidermal hyperplasia, parakeratosis, neutrophils in the stratum corneum, absence of the granular cell layer, thinning of the suprapapillary dermal plates, and tortuous dilated dermal papillary capillaries. Unlike in SD, the sebaceous glands are absent. Severity of SP can be assessed using the Psoriasis Scalp Severity Index (PSSI), which considers percentage of scalp involvement and severity of erythema, infiltration, and desquamation. A dermoscopic scalp psoriasis severity index has also been proposed [1–8].

Fig. 13.1Scalp psoriasis. Erythema and silver white scales

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