Daughter's scalp condition

[borninquisitive]

Dear Dr.,

My daughter has had a scalp condition for awhile. She had an inflamed, weepy area for which one doctor gave her Biaxin. It cleared up. Yet, another area has come to surface. My doctor ran a test and found it not to be fungal nor having head lice. He had wanted her to see a visiting Dermatologist but as it was, she was leaving out of town on a plane the very day and only day that he was taking patients.

In this photo, you will see her scalp condition (as it was, after she itched it): http://i2.photobucket.com/albums/y39/KateInAlaska/scalp.jpg

Do you have ideas of what this is? If so, how and what would you treat this with?
She says that it itches and see that it flakes- somewhat waxy & dry.

As for her forehead, around the hairline it is depigmented. My doctor said this isn't Vitligo and more than likely, having something to do with her scalp condition.
The photo:
http://i2.photobucket.com/albums/y39/KateInAlaska/forehead1.jpg

She doesn't use any tanning products, nor does she go to tanning beds. She has had this for a number of years, as does she have dandruff.

Skin conditions of the scalp exist in our family: seborrhea dermatitis, dandruff and my mother, while young, had eczema on her face.

We will be following up with my doctor on the 28th of this month and both he and I would appreciate your input.
I will print your response for him to review.

Thanks much,
~Kate

[Alan Rockoff, MD]

The lightened skin color looks like post-inflammatory hypopigmentation, which means under-coloration of the skin after some inflammatory condition.  Given the location, that would be scalp psoriasis.

However, the first picture looks like infection or trauma from picking and scratching, not psoriasis.  

That's the best I can do from a distance.  She should use dandruff shampoos and avoid any picking.  If that doesn't work, there are dermatologists even in Alaska.

Best.

Dr. Rockoff

[borninquisitive]

Thank you for the response, I'll pass it onto my doctor.

Yes, there are dermatologists in Alaska. What many folks down south don't realize is, that S.E. is mostly comprised of islands and being small communities, there simply isn't a demand for many medical specialists. Not enough to keep them in business anyway. Our medical facility will not delivery babies, if that gives you an idea.
Anyway, "our" dermatologist resides in Seattle, Washington.

We need to fly or take a ferry out.
This can be costly (Ak. airlines being our only carrier and they "ream" Alaskans on account of the monopoly) and time consuming. Though it is something we have to resort to, when the matter is serious enough. Been there, done that as they say.

So, you see, sites such as this can be quite helpful for us folks.

Thanks again,
~Kate

[Kaela24]

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