Suggest Treatment For Scab Flakes On The Scalp That Is Not Itchy
It might be seborrheic dermatitis.
Detailed Answer:
Hello Sir!
I read carefully your query and understand your concern.
Two most common causes that can cause scaly flakes on the scalp are Seborrhoeic Dermatitis and Psoriasis of the scalp.
Seborrhoeic Dermatitis can be recognised by a dullish red moist scalp. The red areas are covered with greasy looking white or yellowish scales.
The treatment consist in Salicylic Acid,Yeast inhibitors (produced into a cream, lotion or shampoo ),steroid creams.
Psoriasis of the scalp can be recognised by red plaques covered with silver/white scales.
Scalp psoriasis and seborrheic dermatitis of the scalp can be difficult to differentiate.However, the plaques of psoriasis are more persistent, thicker, and a deeper red colour, with large flakes of white scale. Psoriasis is very likely to affect elbows and knees as well as the scalp.
Those with immunodeficiency are particularly prone to seborrheic dermatitis.(in your case from your disease and chemotherapy ).
I would suggest to consult a dermatologist for diagnosis and treatment.
Hope my answer has helped.
Let me know if you have any further question or doubt to clarify.I will be happy to assist you further.
Best Regards!
Dr.Rovena Murati
Thank you for your response. I would like to add a bit more information
regarding my concerns. I am XXXXXXX XXXXXXX XXXXXXX
dictates to me what to write. But since I am his caregiver, I might as well
just write the email myself. I can see better what is on Harold's head than
him. And when we go to see the doctors I have to interpret or repeat what is
said because he can't hear very well and most of the time he does not really
get
(1) It is deffinitely not Psoriasis.
(2) It sounds more like Sebhorric dermatitis, except:
(a) The area affected is mostly contained on the spot where he had the shingles.
Just one side of the head.
(b) He never had this prior to shingles.
(c) The area affected is not overly affected either except on certain spots within
the infected area.
(d) It's more like scabs than scales, yellowish whitish in color. If I leave it alone it
gets bigger and spreads in other parts of the scalp. If I soak it in saline solution
and peel it off, very gently, it comes out raw and and with blood like appearance,
and looks painful, but, XXXXXXX does not complain of pain on the soar but pain
inside the head...in the nerves, like shard headaches, like post neuralgia headaches.
(3) Is it possible that he contacted something like Sebhorric dermatitis
while he had the shingles attack? Or is this Sebhorric dermatitis-like thingy
an outcome of the shingles. Is that possible? I just want to figure out how
and why it started.
When he had the shingles, one side of his head was severely affected all the
way to the ear. He had severe nerve damage too. And the lesions were really
severe and seapping, and that was about three years ago. He has not stopped
going to dermatologists and neurologists in the U.S. and Thailand ever since, and
they still could not get rid of it. We even tried acupuncture.
Is it because of his age?
Some doctors say it is a dermatologist issue.
Some say it is a neurologist issue.
Some say it is a "pain doctor" issue.
We have been to all. Tomorrow we will see an "Infectious desease doctor."
I am trying everything including you. I don't want to leave any stones unturned.
Thank you for your attention and response.
He may need a skin biopsy.
Detailed Answer:
Hello Mrs XXXXXXX !
Hope you are doing well. I apologize for the delay.
There are two issues to discuss in his case:
1-The present lesions in his scalp resembling seborrheic dermatitis and this is managed by a dermatologist.
2-Post-herpetic neuralgia managed by a neurologist. This pain can last months to years after the shingles and the aim of treatment is to control the pain using medications like tricyclic antidepressants, anticonvulsants (pregabalin ) anesthetics, analgesics.
Regarding the lesion in his scalp I may think 2 possibilities:
-Seborrheic dermatitis .
This skin condition is frequent in individuals with weakened immune system.Your husband has a weakened immune system due to his lymphoma and chemotherapy.
There is no clear connection between shingles and seborrheic dermatitis apart the fact that both of these conditions can be caused from immunodeficiency (weakened immune system).
-Another option I can think is that his shingles lesion got infected by a specific microorganism (fungus,bacterium etc) causing these lesions.Probably he didn't got the right treatment for this and this infection now is chronic.
Probably a consult with a Infectious disease doctor is a good idea to get another opinion.
If your husband has been treated for seborrhoic dermatitis or fungal ,bacterial infection and didn't respond to treatment ,probably is time to think a skin biopsy to understand what is causing this.
You can discuss this with his doctor tomorrow.
Hope it was of help.
Wish him quick and complete recovery.
Regards!
Dr.Rovena Murati