Diagnostic and therapeutic approach to scalp dysesthesia: A case series and published work review

J Dermatol. 2019 Jun;46(6):526-530. doi: 10.1111/1346-8138.14901. Epub 2019 May 20.

Abstract

Scalp dysesthesia may be underrecognized but is an important condition which requires special management strategies. Through our case series of four patients, we have noted that patients were frequently misdiagnosed with seborrheic dermatitis and failed standard treatment. However, patients did benefit from low doses of oral pregabalin and a topical compound of amitriptyline, lidocaine and ketamine. Oral antihistamines and topical corticosteroids did not work sufficiently on their own but added value when used in conjunction with analgesic agents. Our experience and published work also suggest the association of cervical spinal changes, psychiatric disorders, and other environmental and habitual factors.

Keywords: TALK; cervical spine; pregabalin; scalp dysesthesia; seborrheic dermatitis.

Publication types

  • Case Reports
  • Review

MeSH terms

  • Administration, Cutaneous
  • Administration, Oral
  • Aged
  • Analgesics / administration & dosage*
  • Cervical Vertebrae
  • Dermatitis, Seborrheic / diagnosis
  • Diagnostic Errors
  • Environmental Exposure / adverse effects
  • Female
  • Glucocorticoids / administration & dosage*
  • Histamine Antagonists / administration & dosage*
  • Humans
  • Mental Disorders / complications
  • Middle Aged
  • Paresthesia / diagnosis*
  • Paresthesia / drug therapy
  • Paresthesia / etiology
  • Paresthesia / psychology
  • Scalp
  • Scalp Dermatoses / diagnosis
  • Spinal Diseases / complications
  • Treatment Outcome

Substances

  • Analgesics
  • Glucocorticoids
  • Histamine Antagonists