Pruritis may be accompanied by hair loss as in tinea capitis, folliculitis.
- With hair loss: tinea capitis, folliculitis decalvans,
- alopecia areata, trichotillomania, lichen planus.
- Without hair loss: Pediculosis capitis, scabies, Pityriasis sicca,
- Contact dermatitis, Psoriasis, Urticaria.
Management: Treatment of the underlying cause.
Dandruff (Pityriasis Simplex)
- It is a non inflammatory and increased scaling on the scalp.This
- increased shedding of dead skin cells from the scalp is known as
- dandruff or in medical term called pityriasis simplex.
- The dry scaly condition is white in colour and usually found over the entire scalp.
On the normal scalp, approximately 4,87,000 cells/ sqcm can be found after a detergent scrub, scalp affected with dandruff liberate upto 8,00,000 cells/sq.cm.
The most common symptom of dandruff is scaling. Itching is occasionally present. The small white flakes are further scattered over the hair shaft and shoulders by scratching, brushing or combing.
There are two types of dandruff- dry scalp dandruff and oily scalp dandruff.
The reasons for dry scalp dandruff are:
- Excessive use of hair sprays and gels.
- Improper use of hair colouring products.
- Excessive use of hot hair dryer.
- Cold weather and indoor heating.
- Tight fitting hats and scarves.
- Frequent shampooing of the hair.
- Stress anxiety and tension.
Causes of oily scalp dandruff:
- Pityrosporum ovale present in sebum.
- Lipase activity.
- Atmospheric humidity.
The condition may remain as a minor irritation throughout a persons life.
As a result of the patchy scaling, the scalp reacts to the scurff by secreting a fluid which causes the scales to stick to the scalp and have a yellowish and waxy appearance.
The condition may spread to the adjacent areas of the head, midline of the head and to the front of the chest and back.
- Ketoconazole 2% shampoo to be used twice in a week for 2 to 4 weeks . Once the dandruff is under control maintainence is done once a week to prevent relapse. Tar shampoos are used in severe cases. Tar inhibits epidermal proliferation.
- Topical corticosteroid lotion or foam is used in extensive inflammatory lesions (Betamethasone Dipropionate, Desonide) for 2 weeks.
- Systemic antifungals can be given in severe cases.