Pityriasis simplex capillitiiL21.0

Author:Prof. Dr. med. Peter Altmeyer

All authors of this article

Last updated on: 29.10.2020

Dieser Artikel auf Deutsch

Synonym(s)

dandruff; Dandruff; dandruff formation; dandruff on the head, dry dandruff; pityriasis capitis

Requires free registration (medical professionals only)

Please login to access all articles, images, and functions.

Our content is available exclusively to medical professionals. If you have already registered, please login. If you haven't, you can register for free (medical professionals only).


Requires free registration (medical professionals only)

Please complete your registration to access all articles and images.

To gain access, you must complete your registration. You either haven't confirmed your e-mail address or we still need proof that you are a member of the medical profession.

Finish your registration now

DefinitionThis section has been translated automatically.

Frequent dermatological problem, which is particularly prevalent in autumn and winter and is characterized by a mostly dry, less often oily dandruff ( pityriasis simplex). Dandruff can be considered a minus variant of a:

occur. If a problem only occurs on the scalp, an etiologic assignment to a disease is often not possible.

The clinical picture of Tinea amiantacea, which can be regarded as the maximum variant of pityriasis simplex capillitii, requires special etiological consideration.

Furthermore, the head ache of the mammal(gneiss) is to be particularly evaluated.

Likewise, the aetiology of "dry dandruff" in adolescents and adults must be given special consideration with regard to its treatment.

Occurrence/EpidemiologyThis section has been translated automatically.

30% of women and about 20% of men suffer at least temporarily from dandruff without any recognisable underlying disease.

EtiopathogenesisThis section has been translated automatically.

Irritation by care products is considered a provocation factor. There are clear indications that Malassezia spp. (see below Pityrosporum) play a decisive role in the pathogenesis of dandruff. In persons with dandruff the population density of Malassezia spp. is strongly increased. The intensity of scaling correlates with the germ density.

Notice! Dry dandruff is often caused by "overtreatment" of the scalp! Remarkable is the evidence of a significantly increased histamine concentration in the dandruff.

Clinical featuresThis section has been translated automatically.

Mostly diffuse, less often circumscribed, scaly, possibly itchy foci on the capillitium. The frequently accompanying itching is regarded as a cascade of different processes that take place in the upper layers of the scalp.

Differential diagnosisThis section has been translated automatically.

TherapyThis section has been translated automatically.

Pityriasis simplex capillitii (PSC) is a constitutional problem. It requires permanent treatment! Compliance indispensable! From the therapeutic approach, pityriasis simplex capillitii with seborrhoea and pityriasis simplex capillitii without seborrhoea must be separated.

  • Pityriasis simplex capillitii with seborrhoea: Treatment with a mild ichthyol-containing preparation is usually sufficient.
  • Shampoos containingpyrithione zinc, selenium disulphide or salicylic acid can be tried alternatively. These inhibit to different degrees the formation of dandruff, the microbial colonization of the scalp and seborrhea. In addition, it is recommended to rub the scalp with an o/w emulsion 1-2 times a week: gently massage it into the scalp in the evening and wash it off the next morning with a mild scalp wash.
  • Pityriasis simplex capillitii with seborrhoea and itching: External therapy as above. In addition, experiment with a menthol-containing or polidocanol-containing formulation (Rp: menthol-containing head tincture; Rp: polidocanol-containing head tincture). Additionally, apply a low-potency glucocorticoid alcoholic solution once a week (e.g. Lygal head tincture, Alpicort-N, Rp: triamcinolone acetonide head tincture 0.05% ).
  • Pityriasis simplex capillitii without seborrhoea (with and without itching): Frequently exaggerated hygiene of the scalp, especially men wash the hairy head frequently daily, usually using unnecessarily large amounts of a liquid shampoo. This results in a latent, toxic-irritative irritation of the scalp with an increased exfoliation of dandruff (washing the head stops dandruff and pruritus by the hour) Circulus vitiosus!
  • Breaking the vicious circle by changing the automatic care system! This is often an amazingly difficult problem. First, avoid liquid shampoos completely. Clean the scalp once a week with soap (e.g. Nivea baby soap).
  • Regular care with an O/W lotion (e.g. Abitima Lotion, Excipial U Lipolotio). Apply lotion to the already moistened capillitium in the shower, distribute and rinse briefly. Normal styling without residual grease on the hair is possible.
  • Alternatively, you can try a nightly oil treatment (head cap) by applying a few drops of a vegetable oil (e.g. almond oil) to the scalp and massaging it in lightly with the fingertips. The oil can be washed off the next day with a mild shampoo and repeated several times a week.
  • In case of severe itching, apply an additional low-potency glucocorticoid alcoholic solution once a week, such as 0.2% prednisolone tincture, possibly in combination with salicylic acid (e.g. Lygal Head Tincture, Alpicort-N).
    It is important to exclude the possibility of Malasessia-furfur colonisation (wood light). If positive, daily treatment (over 1 week) with a 1-2% Clotrimazol solution. Alternatively use a ketoconazole containing solution (e.g. Terzolin) for 1 week.

TablesThis section has been translated automatically.

Topical exteriors in pityriasis simplex capillitii with seborrhoea

Generic drug

Example preparations

For dry scalp

Free of active ingredients

Physiogel Boots, pH5 Eucerin

Tar derivatives

No longer available in the trade; on a magistral formulation with 0.5 - 3.0% CSF carbonis detergens is possible.

Selenium sulphide

Ellsurex

Sulphur

Diasporal

Other

Ducray sail shampoo, Normaker shampoo

In case of heavy scaling

Salicylic acid

squamasol gel

Zinc pyrithione

De-squaman Hermal

Miscellaneous

Ducray Kertyol or Selegel shampoo; Crinohermal anti-dandruff shampoo intensive; Pityker; Stieprox intensive shampoo

Note(s)This section has been translated automatically.

With regard to scalp care, see below skin oils (scalp oils).

LiteratureThis section has been translated automatically.

  1. Kerr K et al (2011) Scalp stratum corneum histamine levels: novel sampling method reveals association with itch resolution in dandruff/seborrhoeic dermatitis treatment. Arch Derm Venereol 91: 404-408
  2. Mayser P et al (2003) The hair strand test - a new method for testing antifungal effects ofantidandruff
    preparations.J Cosmet Sci 54:263-270.
  3. Wohlrab J et al (2017) Local therapy of the scalp. dermatologist 68: 478-482

Authors

Last updated on: 29.10.2020