Scalp rash: Difference between revisions
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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. | 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. | ||
== | == Differentiating a Scalp Rash from other Diseases== | ||
In | 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> | ||
*[[Contact dermatitis]] | *[[Contact dermatitis]] | ||
| Line 25: | Line 25: | ||
*Non-adherent | *Non-adherent | ||
====Bacterial folliculitis==== | ====Bacterial folliculitis==== | ||
*Use intact scalp pustule to determine diagnosis | *Use intact scalp pustule to determine diagnosis. | ||
=== Laboratory Findings === | === Laboratory Findings === | ||
*KOH prep can be done in the office to check for spores within the hair shaft | *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]] | *Fungal cultures can be taken at the site of a kerion or scalp scale to rule out [[tinea capitis]]. | ||
:*Ensure root is intact | :*Ensure root is intact. | ||
*A shave biopsy should not be done liberally | *A shave biopsy should not be done liberally, and it can aid in the determination of [[seborrheic dermatitis]]. | ||
== Treatment == | ==Treatment== | ||
===Medical Therapy=== | ===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 | *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 | ||
=== Injections === | ====Injections==== | ||
=====Discoid lupus===== | |||
====Discoid lupus==== | |||
*Intralesional injection of steroids | *Intralesional injection of steroids | ||
====Dissecting cellulitis==== | =====Dissecting cellulitis===== | ||
*Intralesional steroids | *Intralesional steroids | ||
*Systemic | *Systemic retinoids | ||
*Antibiotic therapy | *Antibiotic therapy | ||
==References== | ==References== | ||
{{Reflist|2}} | {{Reflist|2}} | ||
{{WH}} | |||
{{WS}} | |||
[[Category:Emergency medicine]] | [[Category:Emergency medicine]] | ||
[[Category:Dermatology]] | [[Category:Dermatology]] | ||
[[Category:Medical signs]] | |||
[[Category:Symptoms]] | |||
[[Category:Signs and symptoms]] | [[Category:Signs and symptoms]] | ||
Latest revision as of 00:05, 30 July 2020
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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.
Differentiating a Scalp Rash from other Diseases
- 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, and it can aid in the determination of 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 retinoids
- Antibiotic therapy