Homeopathic Management of Scalp Psoriasis

Introduction

A 21-year-old shop owner, MM, presented with a plaque-like lesion on his scalp, persisting for 1 year. He also reported several other symptoms, including loss of appetite, increased thirst with dryness of mouth, cracked lips, and bleeding per rectum during defecation, associated with fissures in the anal region.

On examination, the lesion was characterized by thickened, scaly plaques and loss of hairs consistent with a diagnosis of scalp psoriasis. The patient's symptoms reflected his discomfort that interfered with his daily activities ([Fig. 1]).

Fig. 1 (A, B) Scalp psoriasis before treatment.

Editor's Note

Scalp psoriasis, although localized to the scalp, shares the same systemic inflammatory pathways that characterize psoriasis as a whole, including activation of the IL-23/IL-17 axis, TNF-α–mediated inflammation, and chronic immune dysregulation. These inflammatory mediators are known contributors to endothelial dysfunction, accelerated atherosclerosis, and microvascular injury. Patients with scalp-predominant psoriasis have been shown to exhibit higher systemic inflammatory burden, partly because scalp involvement is often extensive, persistent, and highly vascular. As a result, scalp psoriasis—despite its cutaneous presentation—may confer an elevated risk of peripheral vascular disease (PVD), similar to other moderate-to-severe psoriasis phenotypes. Mechanistic studies demonstrate increased arterial stiffness, impaired microcirculation, and elevated carotid intima–media thickness in patients with widespread psoriatic inflammation, including those with significant scalp involvement. This supports the emerging concept that scalp psoriasis should not be viewed as a purely dermatologic condition but as a marker of underlying systemic vascular risk requiring early recognition and integrated management.

Patients' Consent

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Publication History

Article published online:
18 November 2024