Treatment of severe scalp psoriasis: From the Medical

Board of the National Psoriasis Foundation
C. Stanley Chan, MD,a Abby S. Van Voorhees, MD,b Mark G. Lebwohl, MD,c Neil J. Korman, MD, PhD,e
Melodie Young, MSN, RN,f Bruce F. Bebo, Jr, PhD,g Robert E. Kalb, MD,d and Sylvia Hsu, MDa
Houston and Dallas, Texas; Philadelphia, Pennsylvania; New York and Buffalo, New York;
Cleveland, Ohio; and Portland, Oregon
Journal of the American Academy of Dermatology 2009; 60(6): 962-71

El 79 % de las personas que padecen psoriasis presentan lesiones que afectan el cuero cabelludo. Sin embargo, pocas son las investigaciones clínicas que se han abocado a estudiar específicamente su manejo, el que, por las características de la zona, difiere del aplicable al resto del cuerpo. En razón de lo antedicho, el consejo médico de la «National Psoriasis Foundation» realizó una revisión sistemática de las evidencias científicas y elaboró las presentes recomendaciones.

Background: The scalp is the most commonly affected part of the body in patients with psoriasis. Signs and symptoms of scalp psoriasis vary significantly for individual patients.

Objective: A task force of the National Psoriasis Foundation was convened to evaluate treatment options. Our aim was to achieve a consensus for scalp psoriasis therapy.

Methods: Reports in the medical literature were reviewed regarding scalp psoriasis therapy.

Limitations: There is a paucity of evidence-based and double-blind studies in the treatment of scalp psoriasis particularly for long-term therapy. Many of the studies in scalp psoriasis were designed to attain Food and Drug Administration approval for a medication and not to provide treatment guidance.

Conclusions: The recommended short-term or intermittent therapy for scalp psoriasis is topical corticosteroids. The primary alternatives are topical retinoids, vitamin D analogues, and salicylic acid.

Combination therapy has many advantages. The choice of an appropriate vehicle is crucial to increase patient compliance. While scalp psoriasis can often be adequately treated with topical therapy, recalcitrant disease may require more aggressive approaches, including systemic agents. ( J Am Acad Dermatol 2009;60:962-71.)

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