It is an eczematous condition in which there is excessive scaling of the scalp. Thick silver –yellow scales are firmly adherent to associated hair and the scalp. The scales bind down the tufts of hair. Considered to be inflammatory skin conditions like psoriasis, seborrhoeic dermatitis, tinea capitis. The scales look like asbestos hence it is also known as Tinea Amiantacea. 

CAUSES:

1. Psoriasis

2. Well-defined red scaly plaques on elbows and knees (chronic plaque psoriasis)

3. Red shiny patches in skin folds (flexural psoriasis)

4. Seborrhoeic dermatitis

5. Patches similar to psoriasis but less well-defined and less red on the scalp and scale tends to be yellowish

6. Tinea capitis

7. Fungal culture might reveal dermatophyte fungus on the scalp.

8. Localized scaly bald patches on the scalp may result in broken or loose hairs.

9. Head lice

10. Egg cases present on the hair shaft and scurrying lice found on the back of the neck and behind ears

11. Possibility of cervical lymph node enlargement

12. Lichen simplex

13. Localized itchy dry patch of skin

14. Often at the back of scalp

15. Thickened, darkened plaques with broken-off hairs due to scratching excessively.

DIAGNOSIS:

1. Since Pityriasis amiantacea symptoms have a close resemblance with other conditions such as psoriasis, seborrhoeic dermatitis or lichen planus.

2. Easily may be misdiagnosed, however, scales, in this case, can be distinguished as they are attached to both hair shaft and the scalp.

3. Skin and hair samples may be used for mycology and scalp biopsy is rarely conducted but depends on an individual case.

TREATMENT:

1. In most cases, topical keratolytic treatment with topical corticosteroids may be suggested as a primary treatment option.

2. Anti-inflammatory topical solution or mineral oil helps detach the adherent scales.

3. Antibiotics are an option if the underlying cause is found to be due to Staphylococcus aureus.

4. Peeling of scabs has to be strictly avoided as it may cause further infection leading to Scarring Alopecia.

5. Anti-fungal treatment is an option in cases in which fungal infection has been suspected.

6. At Royal Hairnic we are assessing the causes diligently as Pityriasis amiantacea can share symptoms of other conditions making diagnosis an important and integral part before proceeding with the treatment.

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