Abstract

Psoriasis is a prolonged immune mediated skin ailment, categorized by erythematous, scaly plaques prime affecting the elbows, knees, scalp, and trunk.Distressing approximately 0.5% to 3% of the global population, psoriasis has a noteworthy impact on quality of life and associated with numerous comorbidities including psoriatic arthritis, cardiovascular disease, and depression. The condition arises from a complex interaction between genetic susceptibility, environmental triggers and immune system regulation. Here is a case 62 year old male patient who reported to the outpatient department with complaints of frequent itching, scaling and erythematous patches over the scalp for the last eight years with erratic exacerbations during winter season. The patient also complained of occasional oozing, tenderness and psychological distress due to constant irritation and visible scaling over hair and shoulders. In ayurveda it can be correlated to Kitibha kustha. This case highlights the longlasting relapsing nature of scalp psoriasis and emphasis. No significant family history of psoriasis was noted. On clinical examination, multiple erythematous, well-demarcated plaques covered with thick, adherent, silvery-white scales were observed over the parietal, frontal, and occipital regions of the scalp. Differential diagnoses considered were seborrheic dermatitis, tinea capitis, and lichen simplex chronicus. However, based on classical clinical findings and diagnostic criteria, a final diagnosis of scalp psoriasis was made. This case highlights the chronic, relapsing nature of scalp psoriasis and emphasizes the need for classical ayurvedic management approaches to control symptoms, improve cosmetic acceptability, and enhance quality of life in geriatric patients. Early recognition, differential diagnosis, and patient-centred holistic care are crucial for long-term management.

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