Dr. Cole is board certified in dermatology. He obtained his BA degree in bacteriology, his MA degree in microbiology, and his MD at the University of California, Los Angeles. He trained in dermatology at the University of Oregon, where he completed his residency.
Dr. Shiel received a Bachelor of Science degree with honors from the University of Notre Dame. There he was involved in research in radiation biology and received the Huisking Scholarship. After graduating from St. Louis University School of Medicine, he completed his Internal Medicine residency and Rheumatology fellowship at the University of California, Irvine. He is board-certified in Internal Medicine and Rheumatology.
Psoriasis is an inflammatory disease of the skin estimated to affect about
2.2% of the adult population. Psoriasis is influenced by the genes that are
inherited from parents. The genes affected seem to be involved with control of
the immune system. Psoriasis appears as red scaling papules the combine into
plaques that are classically present on the elbows and knees but can affect any
part of the skin. The scalp is also characteristically affected in many patients
with psoriasis. Like psoriasis anywhere, scalp plaques produce excess scale and
can itch. Severe disease can cause a loss of scalp hair, which usually will
return if the disease can be controlled.
What is the cause of scalp psoriasis?
The belief that "emotional stress" is a cause of psoriasis is difficult to
support experimentally. There is no question, however, that psoriasis of the
scalp is an extremely stressful experience.
As mentioned above, psoriasis appears as a small bump, a papule, surmounted
by scale. When these papules combine, a plaque is formed that is covered by
excessive layers of horny skin that is perceived as a silvery scale. This scale
is shed and appears as dandruff. The scale and shedding can be quite profuse and
unsightly. Scratching these plaques, either because of itching or because of the
impulse to remove it, is a very poor idea because of what is called the Koebner
phenomenon (also known as the Koebner response or isomorphic response). This is a peculiar predisposition of psoriasis to develop in areas
of trauma. Scratching off the scale will only make things worse. Occasionally
seborrheic dermatitis of the scalp can be confused with psoriasis since both can
produce excess scale and can itch.
Psoriasis PUVA Treatment Can Increase Melanoma Risk
The treatment of psoriasis depends on its severity
and location. Treatments range from local (cortisone cream
application, emollients, coal tar, anthralin preparations, and sun exposure)
to systemic (internal medications, including methotrexateand