Diagnosis of Dandruff
Dandruff Diagnosis: Book Excerpts
Diagnosis of Dandruff: medical news summaries:
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Diagnostic Tests for Dandruff: Online Medical Books
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for more information about diagnostis of Dandruff.
SCALP TENDERNESS:
DIAGNOSTIC WORKUP
(Algorithmic Diagnosis of Symptoms and Signs)
When there are obvious skin lesions, cultures, potassium hydroxide preparations, or biopsies will usually establish the diagnosis. A skull x-ray should be done to exclude fracture, rickets, syphilitic periostitis, and primary and secondary tumors of the cranium. A sedimentation rate should be done to exclude temporal arteritis, especially in the elderly. If the physical examination and diagnostic workup are normal and the patient persists with the complaint, a referral to a psychiatrist is in order.
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Source: Algorithmic Diagnosis of Symptoms and Signs, 2003
Scalp Rash:
Differential Diagnosis
(In a Page: Signs and Symptoms)
- Seborrheic dermatitis (“cradle cap,” “dandruff”)
–The most common scalp condition, it occurs across all age ranges
–May be caused by Pityrosporum ovale
–An inflammatory condition that causes itching and loose, silvery-white scale on scalp, and occasionally blepharitis
–May also affect the eyebrows, nasolabial folds, external auditory canals, chin, anterior chest, upper back, and groin
–Does not cause hair loss
–The scalp is not usually erythematous, but other affected skin areas may be red, greasy, or oily
- Tinea capitis
–Most commonly caused by Trichophyton tonsurans or rarely Microsporum canis
–Presents as patches of scale and/or pruritus with broken hairs, patchy hair loss (i.e., “black dot alopecia”)
–May progress to a kerion (see below)
-
Kerion
–A boggy, tender, subcutaneous fungal
infection (dermatophyte)
–Often has associated drainage and hair loss
Scalp folliculitis
–Presents as recurrent, itchy, crusted papules
or pustules
–An overgrowth of Staphylococcus aureus
- Psoriasis
–Usually presents with plaques of thick, silvery, adherent scalp scale that overlies well-demarcated patches of erythema
–Often occurs at the ears and occipital area
–May be limited to the scalp, but often has skin disease, nail pitting, or nail dystrophy
- Dissecting cellulitis of the scalp
–Chronic, tender, boggy, often suppurative subcutaneous fluctuant masses
–Occurs in black patients
–May be associated with acne keloidalis,
which can cause a scarring hair loss at the occiput
-
Discoid lupus
–Presents initially as well-demarcated erythematous plaques of patchy, scarring scalp hair loss, then spreads centrifugally
Contact dermatitis
Workup and Diagnosis
-
History and physical examination
–If the scalp scale is diffuse, white, and nonadherent, seborrheic dermatitis is the likely diagnosis
Bacterial culture from any intact scalp pustule or suppurating area may be helpful to confirm bacterial folliculitis or dissecting cellulitis
KOH prep of scalp scale or scalp hair can be assessed under a microscope in the office to confirm the presence of endothrix (spores within the hair shaft) in the hair or branching hyphae in the scalp scale Fungal cultures can be obtained from the drainage of a kerion or from scalp scale scraped by a tongue depressor or sterile toothbrush
–Hairs from the affected area can also be sent for fungal culture to rule out tinea capitus; the hairs must be plucked so that the root of the hair is available
–Cultures may take several weeks and sensitivity varies widely based on clinician technique and lab handling
-
A punch or shave biopsy is usually unnecessary, but can aid in the diagnosis of seborrheic dermatitis
-
In cases of tinea capitis, only M. canis, which is uncommon in the U.S., fluoresces with a Wood's lamp
» READ BOOK EXCERPT ONLINE »
Source: In a Page: Signs and Symptoms, 2004
Atopic dermatitis:
Diagnosis
(Professional Guide to Diseases (Eighth Edition))
Typically, the patient has a history of atopy, such as asthma, hay fever, or urticaria; his family may have a similar history. Laboratory tests reveal eosinophilia and elevated serum IgE levels. A skin biopsy may be performed, but it isn’t always required to make the diagnosis.
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Source: Professional Guide to Diseases (Eighth Edition), 2005
Dermatitis:
Diagnosis
(Professional Guide to Diseases (Eighth Edition))
A family history of allergy and chronic inflammation suggests atopic dermatitis. Typical distribution of skin lesions rules out other inflammatory skin lesions, such as diaper rash (lesions are confined to the diapered area), seborrheic dermatitis (no pigmentation changes, or lichenification occurs in chronic lesions), and chronic contact dermatitis (lesions affect hands and forearms, sparing antecubital and popliteal areas). Serum IgE levels are usually elevated.
» READ BOOK EXCERPT ONLINE »
Source: Professional Guide to Diseases (Eighth Edition), 2005
Arthritis/Dermatitis:
Differential Overview
(Field Guide to Bedside Diagnosis)
❑Lyme disease
❑Erythema nodosum
❑Rheumatoid arthritis
❑Systemic lupus erythematosus
❑Psoriatic arthritis
❑Disseminated gonococcemia
❑Sarcoidosis
❑Scleroderma
❑Dermatomyositis
❑Reiter syndrome
❑Rheumatic fever
❑Behçet syndrome
❑Still disease
❑Hypersensitivity vasculitis
» READ BOOK EXCERPT ONLINE »
Source: Field Guide to Bedside Diagnosis, 2007
Dermatitis:
Diagnosis
(Handbook of Diseases)
A family history of atopic disorders is helpful in the diagnosis of atopic dermatitis.
Typical distribution of skin lesions and course rule out other inflammatory skin lesions, such as diaper rash (lesions confined to the diapered area), seborrheic dermatitis, and chronic contact dermatitis (lesions affect hands and forearms, sparing antecubital and popliteal areas). Serum IgE levels are commonly elevated but aren’t diagnostic.
» READ BOOK EXCERPT ONLINE »
Source: Handbook of Diseases, 2003
SCALP TENDERNESS:
Approach to the Diagnosis
(Differential Diagnosis in Primary Care)
Most skin conditions should be easily diagnosed by inspection. A Wood’s
lamp inspection would assist in the diagnosis of tinea capitis. A KOH prep
of scraping may be necessary. Skin biopsy will diagnose other skin
disorders. A sedimentation rate and biopsy of the superficial temporal
artery will diagnose temporal arteritis. If occipital nerve entrapment is
suspected, a nerve block should be done to confirm the diagnosis. X-rays of
the skull and a magnetic resonance imaging (.5ptMRI.5pt) may be necessary, but a
neurologist should be consulted before ordering expensive diagnostic tests.
» READ BOOK EXCERPT ONLINE »
Source: Differential Diagnosis in Primary Care, 2007
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