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Psoriasis
Psoriasis may affect up to 2% of the world's population. Psoriasis
has a genetic component and it seems Caucasians are the most susceptible
ethnic group. The development of psoriasis may occur at any age,
but the most common age for it to begin is when people are in their
mid thirties. It is another inflammatory skin condition that involves
a suspected autoimmune disease mechanism. The exact cause is unknown,
but it has been shown that onset may be preceded by streptococcal
infection or stress in some cases.
Clinically, the scalp is often involved with psoriasis plaques
especially for children and teenagers. Psoriasis most frequently
looks like a bright pink patch that is covered in small scales of
dead skin. In severe cases the entire scalp can be affected and
the scale builds up and forms a sort of cap that can be seen all
over the scalp and may also cover non-hairy areas like the forehead.
Sometimes people with psoriasis are also be susceptible to the development
of seborrheic dermatitis. This may later turn into psoriasis.
As well as directly affecting the skin, psoriasis may also indirectly
cause noticeable hair loss if it develops in hair bearing skin such
as the scalp. The psoriasis plaques (affected patches of skin) may
contain hair follicles that have been forced into the telogen resting
stage by the condition and this results in few visible hairs being
present in the psoriasis plaques. This telogen effluvium is the
typical form of hair loss that psoriasis induces, but sometimes
psoriasis can cause a scarring alopecia. While psoriasis induced
telogen effluvium is fully reversible with successful treatment,
the psoriasis induced scarring alopecia is a permanent form of hair
loss.
Psoriasis cannot be cured, but there are treatments to help control
it. For mild examples of psoriasis a tar shampoo may be all that
is required. More extensive psoriasis may be treated with a shampoo
containing dithranol. If the inflammation is significant the dermatologist
may use a corticosteroid to control it. The corticosteroid treatment
may involve topical creams or sometimes local corticosteroid injections
into the skin are used. Recently, preparations containing calcipotroil
have been shown to be very useful in treating scalp psoriasis.
Psoriasis
references
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AL, van Baar HM, van Gasselt MW, van de Kerkhof PC. The hair
root pattern after calcipotriol treatment for scalp psoriasis.
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L, Bonsmann G, Metze D, Luger TA, Schwarz T. [Scarring psoriatic
alopecia]. Hautarzt. 1995 Mar;46(3):154-7.
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U, Kroneisen-Wiersma P. Psoriatic alopecia: acute and chronic
hair loss in 47 patients with scalp psoriasis. Dermatology.
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- Shuster S. Psoriatic alopecia. Arch Dermatol.
1990 Mar;126(3):397.
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in psoriasis. Acta Derm Venereol. 1990;70(2):156-9.
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Nickoloff BJ, Hamilton TA, Ellis CN, Voorhees JJ. A morphometric
and histologic study of the scalp in psoriasis. Paradoxical
sebaceous gland atrophy and decreased hair shaft diameters without
alopecia. Arch Dermatol. 1989 May;125(5):639-42.
- Siemund J. [Alopecia in vulgar psoriasis
of the scalp. A clinical and histologic report]. Dermatol Monatsschr.
1985;171(1):50-7.
- Burkhart CG. Beau's lines. An association
with pustular psoriasis and telogen effluvium. Arch Dermatol.
1980 Oct;116(10):1l90-1.
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1972 Jul;87(1):73-7.
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