Ann Dermatol.  2016 Aug;28(4):422-426. 10.5021/ad.2016.28.4.422.

Relation between the Peripherofacial Psoriasis and Scalp Psoriasis

• Kim KH
• Ahn JY
• Park MY
• Youn JI

• KMID: 2344810
• DOI: http://doi.org/10.5021/ad.2016.28.4.422

Abstract

BACKGROUND
Facial involvement of psoriasis is known to be one of the clinical manifestations that indicate the severity of the psoriasis and thought to be more closely associated with certain distribution. Centrofacial (CF) psoriasis has been suggested to be related with severity of systemic disease while peripherofacial (PF) psoriasis has been thought to have connection with scalp psoriasis.
OBJECTIVE
To analyze the epidemiologic characteristics, clinical features and subjective feelings of patients with facial psoriasis and to find out relationship between scalp psoriasis and facial involvement according to the facial types.
METHODS
One hundred nineteen facial psoriasis patients were categorized into 3 types according to the distribution: PF type, CF type and mixed facial (MF) type. Onset and duration of facial and scalp psoriasis, and their relationship were questioned. Severity and extent of psoriasis on whole body, face, and scalp were rated by clinicians.
RESULTS
There was no significant difference of whole body psoriasis area and severity index (PASI) and body surface area (BSA) score but scalp PASI and BSA was much higher in PF psoriasis compared to CF psoriasis (scalp PASI, 17.9 vs. 10.1; p=0.005) (scalp BSA, 40.9 vs. 22.2; p=0.002). According to the questionnaire, patient's objective feeling about the spreading of scalp lesion to facial area was markedly more prominent in the patients with peripheral involvement (PF+MF, 90.1%; CF, 54.2%; p<0.0001).
CONCLUSION
Among subtypes of facial psoriasis, PF psoriasis is closely associated with spreading of scalp lesion into the face rather than reflecting the disease severity.

Keyword

Face; Psoriasis; Scalp

MeSH Terms

Body Surface Area
Humans
Psoriasis*
Scalp*

Figure

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  Fig. 1 The proportion of patients who answered to the question, "Does scalp psoriasis spread to the forehead or periauricular area?" according to the types of facial psoriasis. CF: centrofacial, PF: peripherofacial, MF: mixed facial.

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  Fig. 2 The proportion of patients who answered to the question, "If scalp psoriasis spread to the forehead or periauricular area, when?" according to the types of facial psoriasis. CF: centrofacial, PF: peripherofacial, MF: mixed facial.

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  Fig. 3 The proportion of patients who answered to the question, "Does aggravation or improvement of scalp psoriasis related with aggravation or improvement of facial psoriasis?" according to the types of facial psoriasis. CF: centrofacial, PF: peripherofacial, MF: mixed facial.

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  Fig. 4 Diagram of patient's characteristics and histories according to the types of facial psoriasis. CF: centrofacial, PF: peripherofacial, MF: mixed facial, PASI: psoriasis area and severity index.

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