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Image Number 4835 (Psoriasis scalp)


Diagnosis: Psoriasis scalp

Site: Scalp

Sex: M

Age: 30


Description: Thick silvery scale in scalp

Submitted by: Ian McColl

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Differential Diagnosis


 Scalp psoriasis differes from seborrhoeic dermatitis in that the scale is thicker and more extensive and itch is not as prominent a feature. Check for psoriasis elsewhere on the elbows and knees. 

Treatment centres around removing the scale with a keratolytic such as 6% salicylic acid in emulsifying ointment applied overnight for 3 nights followed by a steroid lotion such as Novasone or a combination product such as Daivobet gel. Avoid scratching as this invokes the Koebner reaction which makes the scaling worse. Tar shampoos help delay recurrences.

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