Brief Answer:
Seborrheic dermatitis/scalp psoriasis

Detailed Answer:
Hello and welcome to healthcaremagic

I am Dr. Kakkar. I have gone through your query and I have looked at the photographs.

I would keep possibility of either seborrheic dermatitis of the scalp along with post-inflammatory hypopigmentation Or Scalp psoriasis.

I would like to gather more information from you regarding your concern.

Are there any other red, scaly patches elsewhere on the body?like elbows, knees, back etc

seborrheic dermatitis or Dandruff is an important cause of scalp scaling and itching. Itching is subjective. Clinically there may be ill-defined erythema and greasy scales. Seborrheic dermatitis patients have an overgrowth of yeast, malassezia furfur which may be pathogenetically related/contributes to the inflammation of seborrheic dermatitis

Psoriasis on the other hand, is an inflammatory skin disease characterised by well defined erythematous scaly plaques with silvery white or candle wax type of scaling. Chronic plaque psoriasis is the most common type. It commonly affects the scalp. Other sites that can be affected are arms, and legs, (specifically elbows and knees), palms and soles etc

If I was the treating doctor I would have asked to use an antidandruff lotion/shampoo.

My choice is 2% ketoconazole shampoo, thrice weekly for 2-4 weeks followed by once or twice weekly for maintenance. It is available OTC as Nizral 2% solution. Ketoconazole is antifungal,anti-inflammatory. It inhibits the yeast Malessezia furfur which is present in abundance in seborrheic dermatitis and thus benefits seborrheic dermatitis

Apart from the shampoo, you may use a topical steroid lotion e.g Mometasone furoate lotion over the patches, once or twice daily for 2 weeks.

Once the scaling and patches resolve, you may discontinue the topical steroids. Shampoo should however be continued for maintenance, twice weekly.

regards

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Brief Answer:
Seborrheic dermatitis

Detailed Answer:
Hi.

Fine. Seborrheic dermatitis is my primary diagnosis. A ketoconazole based shampoo, thrice weekly, should be lathered well and left on the scalp for 5-7 minutes.

Topically you may use the steroid lotion e.g Mometasone furoate 0.1%, twice daily for 2 weeks. That should be rapidly effective. It is a prescription drug. The patches should get significantly better in 2 weeks when you can stop the topical steroid lotion. Thereafter just continue with the shampoo for maintenance.

Regards

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