Scalp psoriasis: demographics, clinical features, andtreatment options

Document Type : Original Article

Authors

1 Department of Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran

2 Department of Dermatology, Tehran University of Medical Sciences, Tehran, Iran

3 Autoimmune Bullous Diseases Research Center, Razi Hospital, Tehran University of Medical Sciences, Tehran, Iran

4 Department of Medicine, Tehran University of Medical Sciences, Tehran, Iran

5 Department of Medicine, Iran University of Medical Sciences, Tehran, Iran

6 Department of Pathology, Tehran University of Medical Sciences, Tehran, Iran

Abstract
Background: Psoriasis is a common papulosquamous skin disease and immune system disorder that primarily affects the extensor surfaces of the body and the scalp. Consequently, psoriasis activity can adversely impact patients’ self-esteem and social interactions. This study aims to evaluate the demographics, clinical characteristics, and treatment options of psoriasis patients with scalp involvement.
Methods: This cross-sectional study involved psoriasis patients with scalp involvement who were undergoing treatment and follow-up at our center. Adult patients with scalp psoriasis, without evidence of other skin or rheumatologic disorders, were enrolled. Patient characteristics, clinical findings, and treatment modalities were documented.
Results: Eighty patients with psoriasis involving the scalp were included in the study. The mean age of the patients was 46.49 ± 15.34 years. The average Psoriasis Area and Severity Index (PASI) score was 8.86 ± 9.71. Additionally, the mean intensity of scalp involvement, based on the PASI score, was 1.35 ± 1.30. Plaque-type psoriasis was the most common form, and small seborrheic dermatitis-like scales were the most prevalent presentation of scalp psoriasis.
Conclusion: Scalp involvement in psoriasis is a common presentation of the disease that can mimic seborrheic dermatitis or manifest as adherent peripheral scales or pityriasis amiantacea. We found no relationship between the severity of scalp psoriasis and smoking. However, patients with scalp psoriasis more frequently report hair loss and dissatisfaction with their hair growth, even though their hair pull test may be negative and show no evidence of frank alopecia.

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