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One of the most frequently impacted locations by psoriasis is the scalp. It is seen in about 80% of psoriasis cases worldwide, and its treatment is challenging. To compare the efficacy and safety of excimer light versus topical methotrexate (MTX) 1% hydrogel in treatment of scalp psoriasis. This randomized prospective intra-patient comparative study was carried out on 30 patients with scalp psoriasis. Lesions were divided randomly into two areas: Area A and Area B. Area A received biweekly sessions of 308-nm excimer light and Area B received topical MTX 1% hydrogel once daily for 3 consecutive months. Psoriatic Scalp Severity Index (PSSI), itching score, patient satisfaction and dermoscopic red dots and white scales were used for assessment at the baseline, at the end of treatment protocol and 1 month after the last treatment session. Both treatment modalities induced significant improvement in PSSI, itching score and dermoscopic red dots and white scales (p < 0.001 for each). The mean percentage of improvement of PSSI was 75.82 ± 33.72 in Area A and 74.19 ± 31.64 in Area B with non-significant difference between both areas (p = 0.763). Moreover, the mean percentage reduction of itching score was 77.40 ± 24.61 in Area A and 67.67 ± 34.94 in Area B with non-significant difference between both areas (p = 0.430). Additionally, a notable improvement in dermoscopic red dots and white scales was observed in 83.3% of patients in Area A and in 60% in Area B at the end of treatment protocol with non-significant difference between both areas (p = 0.518) (p = 0.436). Marked patient satisfaction was noticed in both areas with non-significant difference between both areas (p = 0.433). 308-nm excimer light and topical MTX 1% hydrogel are equally safe and effective treatment options for scalp psoriasis with minimal side effects.

Scalp diseases are a common issue affecting patients’ self-esteem and quality of life. Currently, trichoscopy is the foundation of diagnostics; however, it does not always provide sufficient sensitivity and specificity. In uncertain cases, scalp biopsy remains the gold standard, though it is an invasive method and not well accepted by patients. In recent years, new non-invasive diagnostic methods have been developed and modernized. This article discusses imaging techniques, emphasizing their development over time as well as their advantages and limitations in the diagnosis of scalp dermatoses.

Background Head lice infestation is a common public health problem that is most prevalent in primary school children throughout the world, especially in developing countries including different parts of Iran. This study aimed to determine the prevalence and risk factors associated with head lice infestation and pediculicidal effect of 1% permethrin shampoo in primary schools girls of Bashagard County, one of the low socioeconomic areas in southeast of Iran. Methods In this interventional study six villages with similar demographical situations were selected and randomly assigned into intervention and control areas. In each area 150 girl students aged 7–12 years were selected randomly and screened for head lice infestation by visual scalp examination. In intervention area, treatment efficacy of 1% permethrin shampoo was evaluated via re-examination for infestation after one, two, and three weeks. Pre-tested structured questionnaire was used to collect data on socio-demographic and associated factors of head lice infestation. Results The prevalence of head lice infestation was 67.3%. There was significant association between head lice infestation and school grade, family size, parents’ literacy, bathing facilities, frequency of hair washing, and use of shared articles ( p  < 0.05). The effectiveness of 1% permethrin shampoo for head lice treatment was 29.2, 68.9, and 90.3% after the first, second, and third weeks, respectively. Conclusion The head lice infestation is a health problem in primary school girls of Bashagard County. Improvement of socioeconomic status and providing appropriate educational programs about head lice risk factors and prevention can be effective for reduction of infestation in this area. Trial registration This trial has been registered and approved by Hormozgan University of Medical Sciences ethical committee (Trial No.764). Trial registration date: March 17 2014.

Background: There is a need for more effective therapy for scalp psoriasis. Objective: To assess the efficacy and safety of a 2-compound scalp formulation including calcipotriol and betamethasone dipropionate in the treatment of scalp psoriasis. Methods: Patients (n = 218) with scalp psoriasis were randomized to treatment with the 2-compound scalp formulation (n = 108) or betamethasone dipropionate in the same vehicle (n = 110). The treatments were applied once daily on the scalp for up to 8 weeks. Results: The 2-compound scalp formulation showed a significantly higher efficacy than betamethasone dipropionate on the total sign score at the end of treatment (p = 0.042) and after 2 weeks (p = 0.005). Conclusion: The calcipotriol plus betamethasone dipropionate scalp formulation was superior to betamethasone dipropionate in the same vehicle when used once daily for up to 8 weeks in the treatment of scalp psoriasis.

Permethrin is the most widely used pediculicide, but evidence of resistance from several countries and anecdotal reports from Germany suggest that permethrin lotion is now less effective. We designed a randomized, controlled, parallel group trial involving 100 participants with active head louse infestation to investigate the activity of a coconut and anise spray and to see whether permethrin lotion is still effective, using two applications of product 9 days apart. The spray was significantly more successful (41/50, 82.0%) cures compared with permethrin (21/50, 42.0%; p  < 0.0001, difference 40.0%, 95% confidence interval of 22.5% to 57.5%). Per-protocol success was 83.3% and 44.7%, respectively. Thirty-three people reported irritant reactions following alcohol contact with excoriated skin. We concluded that, although permethrin lotion is still effective for some people, the coconut and anise spray can be a significantly more effective alternative treatment.

Lichen planopilaris is a primary lymphocytic cicatricial alopecia that commonly presents with hair loss at the vertex or parietal scalp. Patients may also have associated scalp itching, burning or tenderness. Due to scarring, hair loss is typically permanent. The main goals of treatment are reducing symptoms and preventing disease progression and further hair loss. Currently, the literature has limited evidence on treatments for this difficult condition, and most available evidence is from case reports and case series. Furthermore, the evidence shows a varied response to therapy, with frequent reports of poor response. This article reviews the diagnosis of this rare disease, summarize the currently available treatments, and provide insights and practices from alopecia experts.

Background Recently, the literature has expanded with peer‐reviewed studies on immunomodulatory agents' efficacy on scalp psoriasis—which, in turn, widened knowledge gaps regarding these agents' relative effectiveness. We determined the relative efficacy of immunomodulatory monotherapies for scalp psoriasis. Methods We ran Bayesian network meta‐analyses (NMAs) using outcomes related to Psoriasis Scalp Severity Index (PSSI) and scalp‐specific Physician's Global Assessment of clear (0) or almost clear (1) (Sc‐PGA 0/1). Results We estimated the relative efficacy of 22 interventions (including placebo), and analyzed 9 outcomes, namely: proportion of participants who attained Sc‐PGA 0/1, proportion of participants who achieved 100% improvement in PSSI (PSSI‐100), and proportion of participants who achieved 90% improvement in PSSI (PSSI‐90) at 8, 12, and 16 weeks. Conclusions We are the first to provide comparative evidence on the efficacy of newly investigated agents such as deucravacitinib, tildrakizumab, roflumilast and icotrokinra. In general, the IL‐17 inhibitors (bimekizumab, ixekizumab, secukinumab, brodalumab) and IL‐23 inhibitors (icotrokinra, guselkumab, tildrakizumab) were effective depending upon the outcome and time‐point being considered. At 16 weeks, for PSSI‐100, ixekizumab 150 mg at weeks 0, 2, 4, 8, and 12 ranked highest; at 16 weeks, for Sc‐PGA 0/1 bimekizumab 320 mg every 4 weeks ranked highest; at 8 weeks, for PSSI‐100 ixekizumab 80 mg every 2 weeks ranked highest; at 8 weeks, for Sc‐PGA 0/1 secukinumab 300 mg at weeks 1, 2, 3 and then every 4 weeks ranked highest. Small‐molecule therapies (apremilast, deucravacitinib, roflumilast) improved scalp psoriasis modestly. Our work would guide the design of future studies and clinical decision‐making.

14 January 2026. The article has been temporarily removed due to privacy concerns. It will republish shortly.

Background Care for actinic keratosis (AK) can be improved with more knowledge on the relative of effect of indicated therapies. Objectives Using network meta‐analyses, we quantitatively determined the comparative “short‐term” effects of interventions in adults with facial and scalp AK. Methods On February 28, 2023, evidence from the peer‐reviewed literature was systematically obtained from OVID, the Cochrane Central Register of Controlled Trials and ClinicalTrials.gov. We analyzed data from studies published in English, of a trial design, and investigating the effect of an actinic keratosis monotherapy. Patient complete clearance, patient partial clearance or lesion‐specific clearance across adults were analyzed at 8–12 weeks after therapy. Patient complete clearance pertained to proportion of participants who experienced complete clearance of actinic keratosis lesions; patient partial clearance corresponded to percentage of subjects who achieved at least 75% clearance of actinic keratosis lesions; lesion‐specific clearance represented the percentage of all lesions that were cleared. In the main (i.e., base) analyses, nodes were analyzed only at the level of the agent. Results Data from a total of 84 studies were used—across which 22 active agents were identified. Estimates of interventions' surface under the cumulative ranking curve rankings and (pairwise) relative effects were estimated. Across the three outcomes, fluorouracil 5% was ranked the most effective. Conclusions Our work is the first to provide information on covariate‐adjusted relative effects of actinic keratosis therapies— including the more recently reported treatments—for the face and scalp; this knowledge may help physicians and patients make more informed decisions.

Lipedematous scalp (LS) and lipedematous alopecia (LA) are uncommon conditions with an unclear cause. Over the past century, about 115 cases have been documented in the literature. It is unknown if these disorders are indeed so uncommon or if cases that accept the illness as a structural alteration or are asymptomatic make the disease appear more uncommon than it is. Despite the fact that the majority of cases are seen in young and middle-aged people, the cases involving congenital, elderly, and children have also been reported. In the reported cases, female gender was observed to be dominant. The most significant clinical characteristics include felty swelling of the scalp in both disorders, diffusely or locally enlarged subcutaneous tissue with a swampy, spongy feel, and varied degrees of alopecia in LA. There is still much to learn about the pathogenetic mechanisms and therapeutic approaches for LA and LS. In this article, I review the general clinical characteristics, supposed pathogenetic mechanisms, histopathologic characteristics, diagnostic procedures, and management strategies for LS and LA.