Dermoscopic findings in psoriasis and seborrheic dermatitis on the scalp and correlation with disease severity

Abstract

Dermoscopy has frequently been used for hair and scalp disorders. Dermoscopic examinations of psoriasis and seborrheic dermatitis lesions yielded different morphologies. This study aimed to investigate the usefulness of dermoscopy in the clinical differentiation of psoriasis and seborrheic dermatitis on the scalp and additionally to evaluate its capacity in determining disease severity. The study included 46 psoriasis and 50 seborrheic dermatitis patients who were clinically diagnosed and had scalp lesions. Dermoscopic images taken from lesional scalp were then reviewed for microvascular patterns. In addition, we assessed the severity of scalp disease and looked for a correlation with these patterns. The frequency of twisted loops, glomerular vessels, red dots/globules, and polymorphous beaded lines/circles were statistically higher in the psoriasis group, whereas the frequencies of simple loops and arborizing vessels were statistically higher in the seborrheic dermatitis group (p<0.001). There was no significant difference in the frequency of featureless areas between two groups (p=0.579). There was no correlation with disease severity and dermoscopic findings. In conclusion, dermoscopy is a valuable and easy-to-use tool for differentiating psoriasis and seborrheic dermatitis on the scalp even if it doesn't have enough strength to determine disease severity. In addition, there is some diversity and ambiguity concerning terminology, which can be resolved with future studies and the establishment of conventional terms.

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