Scalp rash: Difference between revisions
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== Overview == | == Overview == | ||
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== Differential diagnosis of causes of a rash on the scalp== | == Differential diagnosis of causes of a rash on the scalp== | ||
In Alphabetical Order. <ref>Sailer, Christian, Wasner, Susanne. Differential Diagnosis Pocket. Hermosa Beach, CA: Borm Bruckmeir Publishing LLC, 2002:77 ISBN 1591032016</ref> <ref>Kahan, Scott, Smith, Ellen G. In A Page: Signs and Symptoms. Malden, Massachusetts: Blackwell Publishing, 2004:68 ISBN 140510368X</ref> | |||
In | |||
*[[Contact dermatitis]] | *[[Contact dermatitis]] | ||
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== Diagnosis == | == Diagnosis == | ||
=== History and Symptoms === | === History and Symptoms === | ||
====Seborrheic dermatitis==== | ====Seborrheic dermatitis==== | ||
* | *Diffuse | ||
* | *White | ||
* | *Non-adherent | ||
====Bacterial folliculitis==== | ====Bacterial folliculitis==== | ||
* | *Use intact scalp pustule to determine diagnosis | ||
=== Laboratory Findings === | === Laboratory Findings === | ||
| Line 37: | Line 32: | ||
:*ensure root is intact | :*ensure root is intact | ||
*A shave biopsy should not be done liberally; can aid in determining [[seborrheic dermatitis]] | *A shave biopsy should not be done liberally; can aid in determining [[seborrheic dermatitis]] | ||
== Treatment == | == Treatment == | ||
===Medical Therapy=== | |||
=== Acute Pharmacotherapies === | === Acute Pharmacotherapies === | ||
====Suborrheic dermatitis==== | ====Suborrheic dermatitis==== | ||
*[[Ketoconazole]] | *[[Ketoconazole]] | ||
*Tar | *Tar | ||
*Salicylic acid shampoos | *Salicylic acid shampoos | ||
*Zinc pyrithione | *Zinc pyrithione | ||
====Tinea capitis==== | ====Tinea capitis==== | ||
*Antifungal therapy | *Antifungal therapy | ||
====Kerion==== | ====Kerion==== | ||
* | *Anti-fungal therapy | ||
*Steroids | *Steroids | ||
====Scalp folliculitis==== | ====Scalp folliculitis==== | ||
*1st generation [[cephalosporin]] or [[tetracycline]] derivative for 2-4 weeks | *1st generation [[cephalosporin]] or [[tetracycline]] derivative for 2-4 weeks | ||
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====Dissecting cellulitis==== | ====Dissecting cellulitis==== | ||
*Intralesional steroids | *Intralesional steroids | ||
* | *Systemic retnoids | ||
* | *Antibiotic therapy | ||
==References== | ==References== | ||
{{Reflist|2}} | {{Reflist|2}} | ||
[[Category:Primary care]] | [[Category:Primary care]] | ||
| Line 81: | Line 66: | ||
[[Category:Signs and symptoms]] | [[Category:Signs and symptoms]] | ||
{{ | {{WH}} | ||
{{ | {{WS}} | ||
Revision as of 16:44, 26 February 2013
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]
Overview
Though diagnosis of scalp dermatitis / infection is easy, treatment can be more difficult. Topical therapy alone, or topical therapy in coordination with systemic therapy for long periods may be essential to maintain complete control of these problems.
Differential diagnosis of causes of a rash on the scalp
In Alphabetical Order. [1] [2]
- Contact dermatitis
- Dissecting cellulitis of the scalp
- Discoid lupus
- Kerion
- Psoriasis
- Scalp folliculitis
- Seborrheic dermatitis
- Tinea capitis
Diagnosis
History and Symptoms
Seborrheic dermatitis
- Diffuse
- White
- Non-adherent
Bacterial folliculitis
- Use intact scalp pustule to determine diagnosis
Laboratory Findings
- KOH prep can be done in the office to check for spores within the hair shaft
- Fungal cultures can be taken at the site of a kerion or scalp scale to rule out tinea capitis
- ensure root is intact
- A shave biopsy should not be done liberally; can aid in determining seborrheic dermatitis
Treatment
Medical Therapy
Acute Pharmacotherapies
Suborrheic dermatitis
- Ketoconazole
- Tar
- Salicylic acid shampoos
- Zinc pyrithione
Tinea capitis
- Antifungal therapy
Kerion
- Anti-fungal therapy
- Steroids
Scalp folliculitis
- 1st generation cephalosporin or tetracycline derivative for 2-4 weeks
Injections
Discoid lupus
- Intralesional injection of steroids
Dissecting cellulitis
- Intralesional steroids
- Systemic retnoids
- Antibiotic therapy