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Managing Scalp Psoriasis: An Evidence-Based Review
Ting-Shun Wang1,2, Tsen-Fang Tsai3
1Department of Dermatology, National Taiwan University Hospital Yun-Lin Branch, Yun-Lin, Taiwan.
American Journal of Clinical Dermatology
|September 22, 2016
Summary
Scalp psoriasis, a common initial presentation of psoriasis, requires more evidence-based treatment guidelines. Current treatments like topical corticosteroids are effective, but advanced therapies like biologics show promise for extensive cases.
Area of Science:
- Dermatology
- Clinical Trials
- Evidence-Based Medicine
Background:
- Scalp psoriasis is a frequent initial manifestation of psoriasis, affecting up to 80% of patients.
- Existing reviews and guidelines lack recent advancements in biologic and small molecule therapies.
Purpose of the Study:
- To provide an up-to-date, evidence-based review of scalp psoriasis treatments.
- To incorporate recent progress in biologic and oral small molecule therapies.
Main Methods:
- Systematic review of 475 PubMed and 845 Embase studies up to May 2016.
- Inclusion of 27 clinical trials, 4 pooled analyses, 10 open-label trials, 1 case series, and 2 case reports.
Main Results:
- Topical corticosteroids and calcipotriol-betamethasone dipropionate are effective first-line treatments.
- Localized phototherapy is superior to generalized for hair-bearing areas.
- Biologics and new small molecules demonstrate efficacy but are limited by cost for extensive scalp psoriasis.
Conclusions:
- Limited randomized controlled trials (RCTs) exist specifically for scalp psoriasis.
- Further controlled studies are necessary for evidence-based treatment approaches.
