[Psoriasis and eczema on the scalp].Hautarzt. 2014 Dec; 65(12):1043-9.H
Diseases of the scalp are a severe burden for affected patients because they are often visible, frequently pruritic and hard to treat. Therefore, a proper diagnosis is extremely important.
If the patient presents with erythematous, scaly skin lesions of the scalp, psoriasis has to be differentiated from atopic eczema, seborrheic eczema and contact eczema (allergic or toxic). The inspection of the entire body as well as a detailed history are essential for establishing the diagnosis.
Topical corticosteroids are the therapeutic agents of choice for all of these scalp diseases. In individual cases immunosuppressive systemic treatments may be required. Azole antimycotics are not only used for seborrheic dermatitis but may also be indicated for treatment of atopic dermatitis or psoriasis of the scalp.
This review provides an overview of the clinical differences between scalp psoriasis and the various forms of eczema and of their therapeutic options. It also highlights the differential diagnosis between toxic and allergic contact eczema of the scalp.