Journal Information
Vol. 100. Issue 7.
Pages 536-543 (September 2009)
Share
Share
Download PDF
More article options
Vol. 100. Issue 7.
Pages 536-543 (September 2009)
Revisión
Full text access
An Update on Scalp Psoriasis
Psoriasis del Cuero Cabelludo
Visits
9692
J. Sola-Ortigosa
Corresponding author
38725jso@comb.es

Correspondence: C/ París, 83-85, 5.a planta. 08029 Barcelona, Spain.
, M. Sánchez-Regaña, P. Umbert-Millet
Unidad de Psoriasis y Fototerapia. Servicio de Dermatología. Hospital Universitario Sagrado Corazón, Barcelona, Spain, Unidad Docente de la Universidad de Barcelona, Barcelona, Spain
This item has received
Article information
Abstract

Between 50% and 80% of patients with psoriasis have involvement of the scalp. The clinical presentation of scalp psoriasis can be very varied, with disease severity ranging from mild to extremely severe. The disease may have a major psychological impact. Treatment should be tailored to each individual in order to achieve a good clinical response or blanching that lasts for as long as possible, with a safe and convenient regimen. Many different treatments have been tried: phototherapy, pulsed magnetic fields, Grenz rays, keratolytics, coal tar, antifungals, dithranol, retinoids, vitamin D analogues, corticosteroids, and systemic treatment. Ideally, for scalp psoriasis, treatment should be effective; applied in the form of a lotion, foam, or emulsion; require few applications per week; and have proven long-term safety. One such treatment is potent corticosteroids and vitamin D3 analogues in combination, which has a fast onset of action and proven longterm safety.

Key words:
psoriasis
scalp
topical treatment
systemic therapy
Resumen

La psoriasis del cuero cabelludo afecta al 50-80% de los pacientes psoriásicos. Su presentación clínica puede ser muy variable: desde una enfermedad leve hasta formas muy graves. Esta condición puede provocar un gran impacto psicológico. El principal objetivo del tratamiento es individualizar el mismo en cada paciente, conseguir una buena respuesta clínica o el blanqueo mediante un tratamiento seguro y cómodo, con una respuesta lo más duradera posible. Se han usado múltiples tratamientos: fototerapia, campos magnéticos pulsátiles, rayos Grenz, queratolíticos, alquitrán de hulla, antifúngicos, ditranol, retinoides, análogos de la vitamina D, corticoesteroides y tratamiento sistémico. El perfil farmacológico ideal para tratar la psoriasis del cuero cabelludo es aquel que sea efectivo, de aplicación intermitente pocas veces por semana en forma de loción, espuma o emulsión y seguro a largo plazo, como la combinación de corticoesteroides potentes y análogos de la vitamina D3, con efecto rápido inicial y seguridad a largo plazo demostrada respectivamente.

Palabras clave:
psoriasis
cuero cabelludo
tratamiento tópico
tratamiento sistémico
Full text is only aviable in PDF
References
[1.]
K. Papp, J. Berth-Jones, K. Kragballe, M. de la Brasinne.
Scalp psoriasis: a review of current topical treatment options.
[2.]
M. Sánchez-Regaña, M. Iglesias, L. Creus, P. Umbert.
Prevalencia de enfermedades hepáticas crónicas en pacientes con psoriasis.
Actas Dermosifiliogr, 91 (2000), pp. 498-510
[3.]
M. Sánchez-Regaña, P. Umbert.
Aspectos diagnósticos y terapéuticos de la psoriasis ungueal.
Actas Dermosifiliogr, 99 (2008), pp. 34-43
[4.]
M. Sánchez-Regaña, R. Ojeda, I. Umbert, P. Umbert, W. Lupo, J. Solé.
El impacto psicosocial de la psoriasis.
Actas Dermosifiliogr, 94 (2003), pp. 11-16
[5.]
Van der Kerkhof, D. de Hoop, J. de Korte, M.V. Kuipers.
Scalp psoriasis, clinical presentations and therapeutic management.
J Dermatol, 197 (1998), pp. 326-334
[6.]
A.K. Gupta, R. Batra, R. Bluhm, T. Boekhout, T.L. Dawson Jr..
Skin diseases associated with Malassezia species.
J Am Acad Dermatol, 51 (2004), pp. 785-798
[7.]
M. Ribera, G. Caballé, N. Fernández, M.J. Fuente, C. Ferrándiz.
Impacto de la psoriasis en la calidad de vida del paciente español.
Piel, 19 (2004), pp. 242-249
[8.]
F. Vanaclocha, L. Puig, E. Daudén, J. Escudero, J.M. Hernanz, C. Ferrándiz, et al.
Validación de la versión española del cuestionario Psoriasis Disability Index en la evaluación de la calidad de vida en pacientes con psoriasis moderada-grave.
Actas Dermosifiliogr, 96 (2005), pp. 659-668
[9.]
S.C. Chen, J. Yeung, M-M. Vhren.
Scalpdex: a quality of-life instrument for scalp dermatitis.
Arch Dermatol, 138 (2002), pp. 803-807
[10.]
M. Sánchez-Regaña, P. Umbert.
Actualización en el tratamiento de la psoriasis.
Dermatología Práctica, 16 (2008), pp. 5-16
[11.]
J. Mason, A.R. Mason, M.J. Cork.
Topical preparations for the treatment of psoriasis: a systematic review.
Br J Dermatol, 146 (2002), pp. 351-364
[12.]
M. Pauporte, H. Maibach, N. Lowe, M. Pugliese, D.J. Friedman, H. Mendelsohn.
Fluocinolone acetonide topical oil for scalp psoriasis.
J Dermatolog Treat, 17 (2004), pp. 1-97
[13.]
M. Jarratt, D. Breneman, A.B. Gottlied, Y. Poulin, Y. Liu, V. Foley.
Clobetasol propionate shampoo 0.05%: a new option to treat patients with moderate to severe scalp psoriasis.
J Drugs Dermatol, 3 (2004), pp. 367-373
[14.]
A.B. Gottlieb, R.O. Ford, M.C. Spellman.
The efficacy and tolerability of clobetasol propionate foam 0.05% in the treatment of mild to moderate plaque-type psoriasis of nonscalp regions.
J Cutan Med Surg, 7 (2003), pp. 185-192
[15.]
D.C. Reid, A.B. Kimball.
Clobetasol propionate foam in the treatment of psoriasis.
Expert Opin Pharmacother, 6 (2005), pp. 1735-1740
[16.]
A. Mazzotta, M. Esposito, I. Carboni, C. Schipani, S. Climenti.
Clobetasol propionate foam 0.05% as a novel topical formulation for plaque-type and scalp psoriasis.
J Derm Treat, 18 (2007), pp. 84-87
[17.]
J. Franz, A. Dawn, J. Myers, J. Hannigan.
Clobetasol propionate foam 0.05%: a novel vehicle with enhanced delivery.
Int J Dermatol, 39 (2000), pp. 521-538
[18.]
T. Ruzicka, C. Trompke.
Treatment of scalp psoriasis. An effective and safe tacalcitol emulsion.
Hautarzt, 55 (2004), pp. 165-170
[19.]
N. Aste.
Tacalcitol ointment in the treatment of psoriasis.
G Ital Dermatol Veneorol, 139 (2004), pp. 81-84
[20.]
L. Barnes, P. Altmeyer, L. Forstrom, M.H. Stenstrom.
Longterm treatment of psoriasis with calcipotriol scalp solution and cream.
Eur J Dermatol, 10 (2000), pp. 199-204
[21.]
C. Buckley, V. Hoffmann, J. Shapiro, S. Saari, F. Cambazard, M. Milsgaard.
Calcipotriol plus betamethasone dipropionate scalp formulation is effective and well tolerated in the treatment of scalp psoriasis: a phase II study.
Dermatology, 217 (2008), pp. 107-113
[22.]
A.V. Anstey, K. Kragballe.
Retrospective assessment of PASI 50 and PASI 75 attainment with a calcipotriol/betamethasone dipropionate ointment.
Int J Dermatol, 45 (2006), pp. 970-975
[23.]
R. Kaufmann, A.J. Bibby, R. Bissonnette, F. Cambazard, A.C. Chu, J. Decroix, et al.
A new calcipotriol/betamethasone dipropionate formulation (Daivobet) is an effective once daily treatment for psoriasis vulgaris.
Dermatology, 205 (2002), pp. 389-393
[24.]
A.M.R. Downs.
Overnight application of Daibovet ointment is effective in scalp psoriasis.
Br J Dermatol, 151 (2004), pp. 52
[25.]
J. Koo, R. Blum, M. Lebwohl.
A randomized, multicenter study of calcipotriene ointment and clobetasol propionate foam in the sequential treatment of localized plaque-type psoriasis: short-and long- term outcomes.
J Am Acad Dermatol, 55 (2006), pp. 637-641
[26.]
C.J. Van der Vleuten, P.C. van der Kerkhof.
Management of scalp psoriasis: guidelines for corticosteroid use in combination treatment.
Drugs, 61 (2001), pp. 1593-1598
[27.]
M. Sánchez-Regaña, E. Dilmé, G. de la Cruz, C. Trullàs, P. Umbert.
Treatment of scalp psoriasis with a non-coal tar shampoo: excellent cosmetic results with no loss of effectiveness.
Proceedings of the 17th European Academy of Dermatology and Venereology, pp. 17-21
[28.]
A. Shemer, N. Nathansohn, B. Kaplan, G. Weiss, N. Newman, H. Trau.
Treatment of scalp seborrheic dermatitis and psoriasis with an ointment of 40% urea and 1% bifonazole.
Int J Dermatol, 39 (2000), pp. 532-534
[29.]
A. Johannesson, B. Lindelof.
Additional effect of Grenz rays on psoriasis lesions of the scalp treated with topical corticosteroids.
Dermatologica, 175 (1987), pp. 290-292
Copyright © 2009. Academia Española de Dermatología y Venereología and Elsevier España, S.L.
Download PDF
Idiomas
Actas Dermo-Sifiliográficas
Article options
Tools
es en

¿Es usted profesional sanitario apto para prescribir o dispensar medicamentos?

Are you a health professional able to prescribe or dispense drugs?