Individuals who suffer from dandruff need to consider the pressure they are facing in life and should be on the watch for worsening dandruff, as it might be a case of psoriasis, doctors said.
Chung Shan Medical University Hospital head Hsiao Yu-ping (蕭玉屏) said there was a case of psoriasis involving a 50-year-old man who worked as an election campaign aide and suffered from severe stress due to preparations for the nine-in-one elections on Nov. 29, adding that the man drank and smoked a lot and often worked all night.
The patient complained of severe dandruff starting in September and he bought over-the-counter drugs in a bid to ease the condition, Hsiao said, adding that the drugs had worsened the condition and caused his scalp to develop pustules that itched severely.
On a visit to the hospital for medication last month, the man was diagnosed with psoriasis after large chunks of hard dandruff and visible lesions on his scalp were found and his fingers exhibited onychomycosis-like symptoms.
Hsiao said he ruled out sebaceous dermatitis and diagnosed him with psoriasis.
The patient was prescribed vitamin D ointment and steroids and medical staff suggested he return to a normal lifestyle with regular sleeping hours, Hsiao said, adding that while the patient has mostly recovered, the condition may relapse if he comes under severe pressure.
Psoriasis is an autoimmune disorder that has unknown causes, Hsiao said, adding that current theories suggest physiology or the environment might cause the increased rate of flesh growth, rapid decrustation and inflammation.
More than 70 percent of psoriasis patients develop the conditions on their scalp, which is often confused as cases of sebaceous dermatitis, Hsiao said.
While ingested steroid medication can be effective, long-term use can cause side effects such as buffalo hump or bloat of the face, Hsiao said, adding that patients have been known to shed dandruff at an increased rate after coming off the medication.
About 1 percent of the population has psoriasis, with most patients developing the condition between the ages of 20 and 60, Hsiao said.
If the condition is not properly seen to, it could lead to an increase in size of the affected area and increased chance of complications such as diabetes or cardio-vascular diseases, Hsiao said, adding that there is also a chance of arthritis.
Psoriasis patients should avoid drinking, smoking and high-pressure jobs, Hsiao said, adding that sometimes having a cold could also be a catalyst for the condition to worsen.
Hsiao also said that winter brings on increased psoriasis symptoms and more than half of psoriasis patients experience a worsening of their condition during the season, adding that there is a 40 percent increase of visits to clinics due to psoriasis over the period.
Hsiao suggested that people change their lifestyles and use anti-dandruff shampoo if they have dandruff and should seek medical help if they do not see an improvement within two months.
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