​Psoriasis is a common, chronic, inflammatory, multisystem disease of the skin and joints. Scalp is the first site of involvement in up to 25% of the patients of psoriasis. Up to 79% of patients of chronic plaque psoriasis may have scalp involvement. It can be mild to severe, and often itchy, cosmetically embarrassing and affects the quality of life adversely.

Scalp psoriasis can be very mild, with slight scaling. It can also be very severe with thick, crusted lesions covering the entire scalp. Psoriasis can extend beyond the hairline onto the forehead or the back of the neck. 
Other skin disorders, such as seborrheic dermatitis, may look similar to psoriasis.

How to differentiate between scalp psoriasis and seborrheic dermatitis of the scalp?

• Scalp psoriasis appears as red lesions with powdery/flaky silvery scales. Psoriasis lesion is more defined and can extend beyond the hairline or appear on the other parts of the body.
• Seborrheic dermatitis appears yellowish and greasy. Patchy scales or crust on the scalp that may be easily removed.
• Scalp psoriasis is often persistent and difficult to treat when compared to seborrheic dermatitis of the scalp.

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A combination of treatment (shampoo, lotion, UV light) will be advised to a person with scalp psoriasis, sometimes the treatment will be rotated since it becomes less responsive to medications after repeated use. Systemic medication may be used if psoriasis is present elsewhere on the body and/or the scalp psoriasis is moderate to severe.

Toasted skin syndrome is characterized as localized areas of reticulated (net-like) reddness and dark pigmentation due to chronic and repeated exposure to infrared radiation. Main cause is repeated exposures to heat at a lower level than that which causes a thermal burn. Other terms used to describe toasted skin syndrome include erythema ab igne, ephelis ignealis, erythema ab calore and fire stains.

Who can develop this syndrome?

• Individuals with medical conditions in which pain is relieved by heating (i.e malignancy, musculoskeletal disorders, etc).
• Occupations/working environments in close proximity to a heat source (ie, cooks, bakers, silversmiths).
• Practice of resting laptops and other electronic devices directly on unprotected skin.

Can it be treated?

• Yes, cessation of heat exposure is first adviced by your dermatologist. Skin lightening creams may be beneficial or laser/ photodyanamic therapy may be suggested by your dermatologist.

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Avoid removing the mole if it is given as an identification mark for government documents such as passport, ration card, etc.

If you have tendency to develop keloids or hypertrophic scars then invasive procedures must be avoided.

Mole with irregular margin and colour should be further analysed to rule out melanoma.

Mole removal can leave behind a scar or pigmentation especially when it is big or deep.

You must follow up after suture removal, your dermatologist may suggest you topical medication to make your scar less prominent. 

Remember, your mole can regrow from the little remnants which may have been left behind. Deeper moles have high chance of regrowth, in such cases multiple sittings may be required for complete removal.