Dermatology -IRCCS Policlinico di Sant'Orsola - Department of Experimental, Diagnostic and Specialty Medicine (DIMES), Alma Mater Studiorum University of Bologna, Bologna, Italy.
Department of Dermatology, University of Padua, Padua, Italy.
J Eur Acad Dermatol Venereol. 2021 Sep;35(9):1830-1837. doi: 10.1111/jdv.17354. Epub 2021 Jun 7.
Scalp psoriasis is often undiagnosed or inadequately treated. The patient himself underestimates the seriousness of this hair disease and consults too late to a dermatologist.
The aim of our study was to create a correlation between the clinical patterns and trichoscopy of scalp psoriasis such in a way to help the clinician to make the diagnosis and select the appropriate therapy.
We gathered all patients affected of scalp psoriasis afferent to Outpatient's hair consultation of the Department of Experimental, Diagnostic and Specialty Medicine, University of Bologna, from January 2012 to December 2018. All patients were evaluated through clinical, trichoscopic examination and a skin biopsy only in doubtful cases. We quantified the severity of the disease with several objective and subjective parameters every 4 months, up to 1 year. We recorded therapies, outcome data and quality of life.
We collected 156 patients affected by scalp psoriasis, identifying seven clinical patterns with specific trichoscopical correlation. In the order of frequency, the clinical patterns were as follows: plaque psoriasis (with a prevalence of erythema, silver-white scales and twisted red loops vessels and red dots); thin scales (with silvery-white scales, simple red lines and signet red ring vessels); sebopsoriasis (with greasy scales, erythema with red dots, globules and twisted and bushy red loops at high magnification); psoriatic cap (with silver-white scales, erythema and polymorphic vascular pattern); pityriasis amiantacea (with yellowish adherent scales, erythema and simple red loops capillaries); cicatricial psoriatic alopecia (with erythema associated with yellowish, silver-white scales with twisted and bushy red loops capillaries) and pustular psoriasis (with 'flower shape' pustular lesions, erythema simple red loops capillaries).
The description of different clinical patterns of scalp psoriasis and its trichoscopical correlations may help the clinician to make the diagnosis also in atypical presentations and to prescribe an adequate therapeutic regimen.
头皮银屑病常被漏诊或治疗不当。患者本人低估了这种毛发疾病的严重性，就诊时间太晚，无法得到皮肤科医生的诊治。
我们旨在创建头皮银屑病的临床和毛发镜表现之间的相关性，以帮助临床医生做出诊断并选择合适的治疗方案。
我们收集了 2012 年 1 月至 2018 年 12 月期间在博洛尼亚大学实验、诊断和专业医学系门诊就诊的所有头皮银屑病患者。所有患者均通过临床、毛发镜检查和皮肤活检进行评估，仅在可疑病例中进行。我们每 4 个月评估一次疾病严重程度，使用多个客观和主观参数，最长达 1 年。我们记录了治疗方法、疗效数据和生活质量。
我们共收集了 156 例头皮银屑病患者，确定了 7 种具有特定毛发镜相关性的临床类型。按频率顺序，这些临床类型如下：斑块状银屑病（以红斑、银白色鳞屑和扭曲的红色环血管和红色点状为特征）；薄鳞屑（表现为银白色鳞屑、单纯红色线条和印章状红色环血管）；皮脂溢出性银屑病（表现为油腻鳞屑、红斑、小滴状和高倍镜下扭曲而浓密的红色环血管）；银屑病帽（银白色鳞屑、红斑和多形性血管模式）；糠疹样银屑病（淡黄色黏附鳞屑、红斑和单纯红色环毛细血管）；瘢痕性银屑病性脱发（红斑伴黄色、银白色鳞屑，扭曲而浓密的红色环毛细血管）和脓疱性银屑病（“花状”脓疱性皮损，红斑，单纯红色环毛细血管）。
头皮银屑病不同临床类型及其毛发镜表现的描述，有助于临床医生在不典型表现时做出诊断，并制定适当的治疗方案。
Zotero 插件