Scalp psoriasis

Psoriasis is a chronic skin disease characterised by inflammation of the skin and hyperproliferation of skin cells. 

Patients with moderate to severe psoriasis may require treatment under the supervision of a dermatologist. 

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In patients with scalp psoriasis a combination of a 10% glycolic acid scalp lotion is used as well as a 0.1% betamethasone scalp application, applied twice daily without any bandage for a period of 8 weeks [16]. 

Kostarelos K, Teknetzis A, Lefaki I, loannides D, Minas A (2000) Double-blind clinical study reveals synergistic action between alpha-hydroxy acid and betamethasone lotions towards topical treatment of scalp psoriasis. J Eur Acad Dermatol Venereol 14(1) 5-9... 

Keratolytic agents such as salicylic acid are often added to bath oil or shampoos (typically 3% to 4%) for scalp psoriasis.10 Salicylic acid can also be added to topical corticosteroid preparations to enhance steroid penetration (salicylic acid breaks down keratin). 

Scalp psoriasis Topical Solution Apply to lesions after combing hair. 

Scalp psoriasis Topical Apply to damp or wet hair and leave on overnight or for at least 4 hr Remove by washing hair with shampoo. 

Initial therapy consisting of twice daily applications of a medium strength topical corticosteroid combined with once daily topical calcipotriene should provide adequate control for this patient s localized psoriasis. A coal tar shampoo should be initiated for her scalp psoriasis with nightly application of a corticosteroid solution to recalcitrant plaques. 

Topical corticosteroids are usually given in combination with other topical treatments for the treatment of chronic plaque psoriasis. Sensitive areas, such as the face, should be treated with a mild corticosteroid and other areas, such as the scalp, with moderate to potent corticosteroids. In general, use should be maintained as early improvements in the condition are not maintained if use is halted. Such a pattern of use may worsen the condition, possibly causing a deterioration of the condition to unstable forms, such as erythrodermic or pustular psoriasis. Co-administration of topical medicaments usually involves alternating administration of each product. Scalp psoriasis is normally treated with softening emollients in combination with salicylic acid with coal tar or sulphur. 

Use Treatment of mild to moderate Half-life Onset Peaks Duration plaque psoriasis. Solution UK UK UK UK Treatment of chronic, moderately severe scalp psoriasis. 

This chapter covers the common scalp conditions that pharmacists are likely to encounter dandruff (pityriasis capitis), seborrhoeic dermatitis, cradle cap, scalp psoriasis and scalp ringworm (tinea capitis). Head lice, another common scalp problem, is covered in Chapter 17. 

The condition may be difficult to differentiate from scalp psoriasis (see below). 

Scalp psoriasis affects about 3% of the population and both sexes equally. 

Scalp psoriasis often extends just below the scalp margin, leaving an inflamed,... 

Thioxolone, a benzoxathiole derivative has been used for local treatment of scalp psoriasis resulting in four cases of scalp and face dermatitis. Whether these cases were allergic or irritant was not shown (Schoeffinius 1972) this chemical sensitized one patient using it for acne treatment (Wahlberg 1971). 

Kuijpers AL, Van Baar HM, Van Gasselt MW, Van de Kerkhof PC (1995) The hair root pattern after calcipotriol treatment for scalp psoriasis. Acta Derm Venereol 75 388-390 Lee KP, Terrill JB, Henry NW (1977) Alopecia induced by inhalation exposure to phenyl glycidyl ether. J Toxicol Environ Health 3 85-87... 

Taneja, A, A. Racette, Z. Gourgouliatos et al.,(2004) Broad-band UVB fiber-optic comb for the treatment of scalp psoriasis a pilot study. International journal of dermatology. 43(6) p. 462-467. Markham, T. and P. Collins,(200I) Topical 5 aminolaevulinic acid photodynamic therapy for extensive scalp actinic keratoses. British Journal of Dermatology. 145(3) p. 502-504. 

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