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Lesions on scalp - need help identifying them!

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amr815
amr815

Hey folks! I'm a current medical student but have yet to receive dermatological training. I'm asking this question on behalf of my brother who came to me with some questions. Planning to get him referred to a dermatologist but wait times are currently 8 months+ and there are no family physicians who sub-specialize in skin conditions available.

He is a 23 y/o male with a history of moderate acne on the face and back (however not similar to chief complaint). No underlying medical conditions, not on any medications, supplements, herbals, etc. Healthy and in shape.

He is presenting with several lesions on his scalp ranging from 0.5 to 2 centimeters in size for the past 7-10 days. The are primarly located on the front and top of his head but noticed a few at the back as well. He describes a mild itch that is intermittent. One lesion was dripping a significant amount of clear liquid (the size of a tear drop) and another appears as a raised skin-coloured lesion on the forehead (no redness, puss, etc. but this one has been present for approximately one month). There are a few others that are less visible due to hair coverage - they are not bleeding but are quite red. He describes that they have a scab-like feeling.

He has not had any recent changes to shampoos, hair products, his skin care regimen, or laundry detergent. No other recent changes to his routine. No recent travel or sick contacts. No known allergies. No smoking or illicit drug use.  Social alcohol consumption. No hair loss or other skin changes noted.

Family history of psoriasis (paternal grandfather) and possibly eczema, but nobody in the family has presented with scalp lesions like these to our knowledge.

Anyone have any idea what this could be, and thoughts on how to treat it? I don't have enough knowledge on the subject to provide any help. I've attached some photos for reference (1 flat lesion, 2 weeping lesions, and 1 of the smaller red lesions).

Thanks!

0 likes, 3 replies

3 Replies

  • louiselost
    louiselost amr815

    Posted

    It might be scalp eczema which responds to treatment but often returns.  Possibly have him use a medicated dandruff shampoo and see if that doesn't clear it up.

    There are so many skin disorders that baffle dermatologists, but with your family history of psoriasis/eczema your brother may be especially prone in this case.

    It's a good sign the lesions aren't bleeding as that would lead to infection.

  • blaine06540
    blaine06540 amr815

    Posted

    Hello, have you had any updates or developments on this scalp issue? My partner is 23 now and has had the same thing in a few places on his scalp for about four months now. He has a similar history to your brother, although he occasionally smokes, and does not have a history of acne. He has been given two creams and a shampoo from the doctor which have not helped and is still waiting to see a dermatologist.
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