Practical Approach to Scaling Scalp
Abstract
Scaling scalp or scalp hyperkeratosis is the common symptom bringing patients to the hospital. Scaling scalp does not only cause irritation and discomfort to the patients but also leads to socializing problems due to its obvious presentations. Dandruff or pityriasis capitis, seborrheic dermatitis, scalp psoriasis, tinea capitis and scalp eczema are among the most common diseases. Until now, there are variety of breakthrough innovations helping physicians and dermatologists in making more accurate diagnosis and treating patients more effective. This reviewing article is aiming to update current knowledge in diseases, investigations and treatments of scaling scalp.
References
1. Borda LJ, Wikramanayake TC. Seborrheic Dermatitis and Dandruff: A Comprehensive Review. J Clin Investig Dermatol 2015;3.
2. Hay RJ. Malassezia, dandruff and seborrhoeic dermatitis: an overview. Br J Dermatol 2011; 165: 2-8.
3. Blanes M, Belinchon I, Merino E, et al. [Current prevalence and characteristics of dermatoses associated with human immunodeficiency virus infection]. Actas Dermosifiliogr 2010; 101: 702-9.
4. Dunic I, Vesic S, Jevtovic DJ. Oral candidiasis and seborrheic dermatitis in HIV-infected patients on highly active antiretroviral therapy. HIV Med 2004;5:50-4.
5. Mathes BM, Douglass MC. Seborrheic dermatitis in patients with acquired immunodeficiency syndrome. J Am Acad Dermatol 1985;13:947-51.
6. Osei-Sekyere B, Karstaedt AS. Immune reconstitution inflammatory syndrome involving the skin. Clin Exp Dermatol 2010;35:477-81.
7. Burton JL, Pye RJ. Seborrhoea is not a feature of seborrhoeic dermatitis. Br Med J (Clin Res Ed). 1983; 286: 1169-70.
8. Tajima M, Sugita T, Nishikawa A, et al. Molecular analysis of Malassezia microflora in seborrheic dermatitis patients: comparison with other diseases and healthy subjects. J Invest Dermatol 2008;128:345-51.
9. DeAngelis YM, Gemmer CM, Kaczvinsky JR, et al. Three etiologic facets of dandruff and seborrheic dermatitis: Malassezia fungi, sebaceous lipids, and individual sensitivity. J Investig Dermatol Symp Proc 2005;10:295-7.
10. Pierard-Franchimont C, Pierard GE, Arrese JE, et al. Effect of ketoconazole 1% and 2% shampoos on severe dandruff and seborrhoeic dermatitis: clinical, squamometric and mycological assessments. Dermatology 2001;202:171-6.
11. Pierard-Franchimont C, Goffin V, Decroix J, et al. A multicenter randomized trial of ketoconazole 2% and zinc pyrithione 1% shampoos in severe dandruff and seborrheic dermatitis. Skin Pharmacol Appl Skin Physiol 2002;15:434-41.
12. Danby FW, Maddin WS, Margesson LJ, et al. A randomized, double-blind, placebo-controlled trial of ketoconazole 2% shampoo versus selenium sulfide 2.5% shampoo in the treatment of moderate to severe dandruff. J Am Acad Dermatol 1993;29:1008-12.
13. Gupta AK, Richardson M, Paquet M. Systematic review of oral treatments for seborrheic dermatitis. J Eur Acad Dermatol Venereol 2014;28:16-26.
14. Lambert DR, Siegle RJ, Camisa C. Griseofulvin and ketoconazole in the treatment of dermatophyte infections. Int J Dermatol 1989;28:300-4.
15. Okokon EO, Verbeek JH, Ruotsalainen JH, Ojo OA, Bakhoya VN. Topical antifungals for seborrhoeic dermatitis. Cochrane Database Syst Rev 2015: CD008138.
16. Kastarinen H, Oksanen T, Okokon EO, et al. Topical anti-inflammatory agents for seborrhoeic dermatitis of the face or scalp. Cochrane Database Syst Rev 2014:CD009446.
17. Lebwohl M. Psoriasis. Lancet 2003;361:1197-204.
18. Sola-Ortigosa J, Sanchez-Regana M, UmbertMillet P. [An update on scalp psoriasis]. Actas Dermosifiliogr 2009; 100: 536-43.
19. Krueger G, Koo J, Lebwohl M, et al. The impact of psoriasis on quality of life: results of a 1998 National Psoriasis Foundation patientmembership survey. Arch Dermatol 2001; 137:280-4.
20. Ortonne J, Chimenti S, Luger T, et al. Scalp psoriasis: European consensus on grading and treatment algorithm. J Eur Acad Dermatol Venereol 2009; 23: 1435-44.
21. George SM, Taylor MR, Farrant PB. Psoriatic alopecia. Clin Exp Dermatol 2015;40:717-21.
22. Cockayne SE, Messenger AG. Familial scarring alopecia associated with scalp psoriasis. Br J Dermatol 2001;144:425-7.
23. Kim GW, Jung HJ, Ko HC, et al. Dermoscopy can be useful in differentiating scalp psoriasis from seborrhoeic dermatitis. Br J Dermatol 2011; 164: 652-6.
24. Kibar M, Aktan S, Bilgin M. Dermoscopic findings in scalp psoriasis and seborrheic dermatitis; two new signs; signet ring vessel and hidden hair. Indian J Dermatol 2015;60:41-5.
25. Ross EK, Vincenzi C, Tosti A. Videodermoscopy in the evaluation of hair and scalp disorders. J Am Acad Dermatol 2006;55:799-806.
26. Iamsumang W, Sriphojanart T, Suchonwanit P. Psoriatic Alopecia in a Patient with Systemic Lupus Erythematosus. Case Rep Dermatol 2017;9:51-9.
27. Wang TS, Tsai TF. Managing Scalp Psoriasis: An Evidence-Based Review. Am J Clin Dermatol 2017; 18:17-43.
28. Dermatological Society of Thailand [Internet]. Clinical Practice Guideline for Psoriasis 2011; 2011 [cited 2017 Dec 16]. Available from: https://www.dst.or.th/Physician/Articles/435.29.0/ yYLY4tzYM0.
29. Puig L, Ribera M, Hernanz JM, et al. [Treatment of scalp psoriasis: review of the evidence and Delphi consensus of the Psoriasis Group of the Spanish Academy of Dermatology and Venereology]. Actas Dermosifiliogr 2010; 101: 827-46.
30. Schlager JG, Rosumeck S, Werner RN, et al. Topical treatments for scalp psoriasis. Cochrane Database Syst Rev 2016;2:CD009687.
31. Fotiadou C, Lazaridou E, Sotiriou E, et al. Scalp psoriasis and biologic agents: a retrospective, comparative study from a tertiary psoriasis referral centre. J Eur Acad Dermatol Venereol. 2016; 30: 2091-6.
32. Hay RJ. Tinea Capitis: Current Status. Mycopathologia. 2017; 182: 87-93.
33. Elewski BE. Tinea capitis: a current perspective. J Am Acad Dermatol 2000; 42: 1-20; quiz 1-4.
34. Fuller LC, Barton RC, Mohd Mustapa MF, et al. British Association of Dermatologists' guidelines for the management of tinea capitis 2014. Br J Dermatol 2014;171:454-63.
35. Ekiz O, Sen BB, Rifaioglu EN, Balta I. Trichoscopy in paediatric patients with tinea capitis: a useful method to differentiate from alopecia areata. J Eur Acad Dermatol Venereol 2014;28:1255-8.
36. Slowinska M, Rudnicka L, Schwartz RA, et al. Comma hairs: a dermatoscopic marker for tinea capitis: a rapid diagnostic method. J Am Acad Dermatol 2008; 59:S77-9.
37. Neri I, Starace M, Patrizi A, Balestri R. Corkscrew hair: a trichoscopy marker of tinea capitis in an adult white patient. JAMA Dermatol 2013;149:990-1.
38. Lacarrubba F, Verzi AE, Micali G. Newly described features resulting from high-magnification dermoscopy of tinea capitis. JAMA Dermatol 2015;151:308-10.
39. Wang HH, Lin YT. Bar code-like hair: dermoscopic marker of tinea capitis and tinea of the eyebrow. J Am Acad Dermatol 2015;72:S41-2.
40. Dermatological Society of Thailand [Internet]. Clinical Practice Guideline Superficial Fungal Infection 2011; 2011 [cited 2017 Dec 16]. Available from: https://www.dst.or.th/Physician/Articles/433.29.0/ 5LNWbWTDDb.
41. Chen X, Jiang X, Yang M, et al. Systemic antifungal therapy for tinea capitis in children. Cochrane Database Syst Rev. 2016:CD004685.
42. Tey HL, Tan AS, Chan YC. Meta-analysis of randomized, controlled trials comparing griseofulvin and terbinafine in the treatment of tinea capitis. J Am Acad Dermatol 2011;64:663- 70.
43. Koumantaki-Mathioudaki E, DevliotouPanagiotidou D, Rallis E, et al. Is itraconazole the treatment of choice in Microsporum canis tinea capitis? Drugs Exp Clin Res 2005; 31:11-5.
44. Proudfoot LE, Higgins EM, Morris-Jones R. A retrospective study of the management of pediatric kerion in Trichophyton tonsurans infection. Pediatr Dermatol 2011;28:655-7.
45. Hussain I, Muzaffar F, Rashid T, et al. A randomized, comparative trial of treatment of kerion celsi with griseofulvin plus oral prednisolone vs. griseofulvin alone. Med Mycol 1999;37:97-9.
46. Nenoff P, Kruger C, Paasch U, Ginter-Hanselmayer G. Mycology-an update Part 3: Dermatomycoses: topical and systemic therapy. J Dtsch Dermatol Ges 2015;13:387-410; quiz 441.
47. Kakourou T, Uksal U. Guidelines for the management of tinea capitis in children. Pediatr Dermatol 2010;27:226-8.
48. Goh CL. Eczema of the face, scalp and neck: an epidemiological comparison by site. J Dermatol 1989;16:223-6.
49. Hillen U, Grabbe S, Uter W. Patch test results in patients with scalp dermatitis: analysis of data of the Information Network of Departments of Dermatology. Contact Dermatitis 2007;56:87-93.
50. Knight AG. Pityriasis amiantacea: a clinical and histopathological investigation. Clin Exp Dermatol 1977;2:137-43.
51. McGinley KJ, Leyden JJ, Marples RR, Kligman AM. Quantitative microbiology of the scalp in nondandruff, dandruff, and seborrheic dermatitis. J Invest Dermatol 1975;64:401-5.
52. Abdel-Hamid IA, Agha SA, Moustafa YM, EILabban AM. Pityriasis amiantacea: a clinical and etiopathologic study of 85 patients. Int J Dermatol 2003;42:260-4.
2. Hay RJ. Malassezia, dandruff and seborrhoeic dermatitis: an overview. Br J Dermatol 2011; 165: 2-8.
3. Blanes M, Belinchon I, Merino E, et al. [Current prevalence and characteristics of dermatoses associated with human immunodeficiency virus infection]. Actas Dermosifiliogr 2010; 101: 702-9.
4. Dunic I, Vesic S, Jevtovic DJ. Oral candidiasis and seborrheic dermatitis in HIV-infected patients on highly active antiretroviral therapy. HIV Med 2004;5:50-4.
5. Mathes BM, Douglass MC. Seborrheic dermatitis in patients with acquired immunodeficiency syndrome. J Am Acad Dermatol 1985;13:947-51.
6. Osei-Sekyere B, Karstaedt AS. Immune reconstitution inflammatory syndrome involving the skin. Clin Exp Dermatol 2010;35:477-81.
7. Burton JL, Pye RJ. Seborrhoea is not a feature of seborrhoeic dermatitis. Br Med J (Clin Res Ed). 1983; 286: 1169-70.
8. Tajima M, Sugita T, Nishikawa A, et al. Molecular analysis of Malassezia microflora in seborrheic dermatitis patients: comparison with other diseases and healthy subjects. J Invest Dermatol 2008;128:345-51.
9. DeAngelis YM, Gemmer CM, Kaczvinsky JR, et al. Three etiologic facets of dandruff and seborrheic dermatitis: Malassezia fungi, sebaceous lipids, and individual sensitivity. J Investig Dermatol Symp Proc 2005;10:295-7.
10. Pierard-Franchimont C, Pierard GE, Arrese JE, et al. Effect of ketoconazole 1% and 2% shampoos on severe dandruff and seborrhoeic dermatitis: clinical, squamometric and mycological assessments. Dermatology 2001;202:171-6.
11. Pierard-Franchimont C, Goffin V, Decroix J, et al. A multicenter randomized trial of ketoconazole 2% and zinc pyrithione 1% shampoos in severe dandruff and seborrheic dermatitis. Skin Pharmacol Appl Skin Physiol 2002;15:434-41.
12. Danby FW, Maddin WS, Margesson LJ, et al. A randomized, double-blind, placebo-controlled trial of ketoconazole 2% shampoo versus selenium sulfide 2.5% shampoo in the treatment of moderate to severe dandruff. J Am Acad Dermatol 1993;29:1008-12.
13. Gupta AK, Richardson M, Paquet M. Systematic review of oral treatments for seborrheic dermatitis. J Eur Acad Dermatol Venereol 2014;28:16-26.
14. Lambert DR, Siegle RJ, Camisa C. Griseofulvin and ketoconazole in the treatment of dermatophyte infections. Int J Dermatol 1989;28:300-4.
15. Okokon EO, Verbeek JH, Ruotsalainen JH, Ojo OA, Bakhoya VN. Topical antifungals for seborrhoeic dermatitis. Cochrane Database Syst Rev 2015: CD008138.
16. Kastarinen H, Oksanen T, Okokon EO, et al. Topical anti-inflammatory agents for seborrhoeic dermatitis of the face or scalp. Cochrane Database Syst Rev 2014:CD009446.
17. Lebwohl M. Psoriasis. Lancet 2003;361:1197-204.
18. Sola-Ortigosa J, Sanchez-Regana M, UmbertMillet P. [An update on scalp psoriasis]. Actas Dermosifiliogr 2009; 100: 536-43.
19. Krueger G, Koo J, Lebwohl M, et al. The impact of psoriasis on quality of life: results of a 1998 National Psoriasis Foundation patientmembership survey. Arch Dermatol 2001; 137:280-4.
20. Ortonne J, Chimenti S, Luger T, et al. Scalp psoriasis: European consensus on grading and treatment algorithm. J Eur Acad Dermatol Venereol 2009; 23: 1435-44.
21. George SM, Taylor MR, Farrant PB. Psoriatic alopecia. Clin Exp Dermatol 2015;40:717-21.
22. Cockayne SE, Messenger AG. Familial scarring alopecia associated with scalp psoriasis. Br J Dermatol 2001;144:425-7.
23. Kim GW, Jung HJ, Ko HC, et al. Dermoscopy can be useful in differentiating scalp psoriasis from seborrhoeic dermatitis. Br J Dermatol 2011; 164: 652-6.
24. Kibar M, Aktan S, Bilgin M. Dermoscopic findings in scalp psoriasis and seborrheic dermatitis; two new signs; signet ring vessel and hidden hair. Indian J Dermatol 2015;60:41-5.
25. Ross EK, Vincenzi C, Tosti A. Videodermoscopy in the evaluation of hair and scalp disorders. J Am Acad Dermatol 2006;55:799-806.
26. Iamsumang W, Sriphojanart T, Suchonwanit P. Psoriatic Alopecia in a Patient with Systemic Lupus Erythematosus. Case Rep Dermatol 2017;9:51-9.
27. Wang TS, Tsai TF. Managing Scalp Psoriasis: An Evidence-Based Review. Am J Clin Dermatol 2017; 18:17-43.
28. Dermatological Society of Thailand [Internet]. Clinical Practice Guideline for Psoriasis 2011; 2011 [cited 2017 Dec 16]. Available from: https://www.dst.or.th/Physician/Articles/435.29.0/ yYLY4tzYM0.
29. Puig L, Ribera M, Hernanz JM, et al. [Treatment of scalp psoriasis: review of the evidence and Delphi consensus of the Psoriasis Group of the Spanish Academy of Dermatology and Venereology]. Actas Dermosifiliogr 2010; 101: 827-46.
30. Schlager JG, Rosumeck S, Werner RN, et al. Topical treatments for scalp psoriasis. Cochrane Database Syst Rev 2016;2:CD009687.
31. Fotiadou C, Lazaridou E, Sotiriou E, et al. Scalp psoriasis and biologic agents: a retrospective, comparative study from a tertiary psoriasis referral centre. J Eur Acad Dermatol Venereol. 2016; 30: 2091-6.
32. Hay RJ. Tinea Capitis: Current Status. Mycopathologia. 2017; 182: 87-93.
33. Elewski BE. Tinea capitis: a current perspective. J Am Acad Dermatol 2000; 42: 1-20; quiz 1-4.
34. Fuller LC, Barton RC, Mohd Mustapa MF, et al. British Association of Dermatologists' guidelines for the management of tinea capitis 2014. Br J Dermatol 2014;171:454-63.
35. Ekiz O, Sen BB, Rifaioglu EN, Balta I. Trichoscopy in paediatric patients with tinea capitis: a useful method to differentiate from alopecia areata. J Eur Acad Dermatol Venereol 2014;28:1255-8.
36. Slowinska M, Rudnicka L, Schwartz RA, et al. Comma hairs: a dermatoscopic marker for tinea capitis: a rapid diagnostic method. J Am Acad Dermatol 2008; 59:S77-9.
37. Neri I, Starace M, Patrizi A, Balestri R. Corkscrew hair: a trichoscopy marker of tinea capitis in an adult white patient. JAMA Dermatol 2013;149:990-1.
38. Lacarrubba F, Verzi AE, Micali G. Newly described features resulting from high-magnification dermoscopy of tinea capitis. JAMA Dermatol 2015;151:308-10.
39. Wang HH, Lin YT. Bar code-like hair: dermoscopic marker of tinea capitis and tinea of the eyebrow. J Am Acad Dermatol 2015;72:S41-2.
40. Dermatological Society of Thailand [Internet]. Clinical Practice Guideline Superficial Fungal Infection 2011; 2011 [cited 2017 Dec 16]. Available from: https://www.dst.or.th/Physician/Articles/433.29.0/ 5LNWbWTDDb.
41. Chen X, Jiang X, Yang M, et al. Systemic antifungal therapy for tinea capitis in children. Cochrane Database Syst Rev. 2016:CD004685.
42. Tey HL, Tan AS, Chan YC. Meta-analysis of randomized, controlled trials comparing griseofulvin and terbinafine in the treatment of tinea capitis. J Am Acad Dermatol 2011;64:663- 70.
43. Koumantaki-Mathioudaki E, DevliotouPanagiotidou D, Rallis E, et al. Is itraconazole the treatment of choice in Microsporum canis tinea capitis? Drugs Exp Clin Res 2005; 31:11-5.
44. Proudfoot LE, Higgins EM, Morris-Jones R. A retrospective study of the management of pediatric kerion in Trichophyton tonsurans infection. Pediatr Dermatol 2011;28:655-7.
45. Hussain I, Muzaffar F, Rashid T, et al. A randomized, comparative trial of treatment of kerion celsi with griseofulvin plus oral prednisolone vs. griseofulvin alone. Med Mycol 1999;37:97-9.
46. Nenoff P, Kruger C, Paasch U, Ginter-Hanselmayer G. Mycology-an update Part 3: Dermatomycoses: topical and systemic therapy. J Dtsch Dermatol Ges 2015;13:387-410; quiz 441.
47. Kakourou T, Uksal U. Guidelines for the management of tinea capitis in children. Pediatr Dermatol 2010;27:226-8.
48. Goh CL. Eczema of the face, scalp and neck: an epidemiological comparison by site. J Dermatol 1989;16:223-6.
49. Hillen U, Grabbe S, Uter W. Patch test results in patients with scalp dermatitis: analysis of data of the Information Network of Departments of Dermatology. Contact Dermatitis 2007;56:87-93.
50. Knight AG. Pityriasis amiantacea: a clinical and histopathological investigation. Clin Exp Dermatol 1977;2:137-43.
51. McGinley KJ, Leyden JJ, Marples RR, Kligman AM. Quantitative microbiology of the scalp in nondandruff, dandruff, and seborrheic dermatitis. J Invest Dermatol 1975;64:401-5.
52. Abdel-Hamid IA, Agha SA, Moustafa YM, EILabban AM. Pityriasis amiantacea: a clinical and etiopathologic study of 85 patients. Int J Dermatol 2003;42:260-4.
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Published
2017-12-01
How to Cite
Harnchoowong, S., Suchonwanit, P., & Khunkhet, S. (2017). Practical Approach to Scaling Scalp. Thai Journal of Dermatology, 33(4), 239–257. Retrieved from https://he02.tci-thaijo.org/index.php/TJD/article/view/159077
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เนื้อหาและข้อมูลในบทความที่ลงตีพิมพ์ในวารสารโรคผิวหนัง ถือเป็นข้อคิดเห็นและความรับผิดชอบของผู้เขียนบทความโดยตรงซึ่งกองบรรณาธิการวารสาร ไม่จำเป็นต้องเห็นด้วย หรือร่วมรับผิดชอบใดๆ
บทความ ข้อมูล เนื้อหา รูปภาพ ฯลฯ ที่ได้รับการตีพิมพ์ในวารสารโรคผิวหนัง ถือเป็นลิขสิทธิ์ของวารสารฯ หากบุคคลหรือหน่วยงานใดต้องการนำทั้งหมดหรือส่วนหนึ่งส่วนใดไปเผยแพร่ต่อหรือเพื่อกระทำการใดๆ จะต้องได้รับอนุญาตเป็นลายลักอักษรจากบรรณาธิการวารสารโรคผิวหนังก่อนเท่านั้น
