Get your health question answered instantly from our pool of 18000+ doctors from over 80 specialties

138 Doctors Online
Doctor Image
Dr. Andrew Rynne

Family Physician

Exp 50 years

I will be looking into your question and guiding you through the process. Please write your question below.

What causes an itchy scalp that shed small piece of skin and some blood when scratched?

Answered by
Dr. Kakkar S.


Practicing since :2002

Answered : 8350 Questions

Posted on Thu, 30 Aug 2018 in Skin Hair and Nails
Question: scalp dermatitis in 75 year old male bald on top. I have been having some type of problem with the skin on the top of my head where I have had no hair for many years. It does not bother much but occassionally it gets itchy and so I then scratch it and then discover small pieces of skin that will come out of the skin when I do scratch it. These can be ofter fairly big and deep to the point that when I pick on them, they will bleed. I am taking metoprolol for my blood pressure so maybe that is the problem? If so I wonder what BP med I should try next? I have been suffering from a statin drug induced SLE for about 20 years and have had to be on prednisone for the past 4 years to relieve my aches, pains and fatigue s/s so maybe that is responsible? I have cut the prednisone down now to 8 mg per day but decreasing the dose does not seem to have done much.
Answered by Dr. Kakkar S. 1 hour later
Brief Answer:
Diagnostic possibilities for itchy scalp scaly patches /plaques

Detailed Answer:

I am Dr kakkar (Dermatologist and Venereologist). I have noted your concern.

It could be either scalp DLE (Discoid Lupus Erythematous) which presents as patches/plaques with adherent white scaling, atrophy and depigmentation Or it may be Seborrheic dermatitis of the scalp which presents as dull red patches with yellowish greasy scaling and scalp itching.
I request you to kindly upload a few images of the affected area so that I am able to confirm and guide you better.

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
Follow up: Dr. Kakkar S. 12 hours later
did you get the photos?
Answered by Dr. Kakkar S. 29 minutes later
Brief Answer:
Images not received

Detailed Answer:
No. I didn't. I request you to kindly try and upload the images again in "Reports Section" or else you may mail me the images at YYYY@YYYY with the subject line of the mail as Attention :Dr.. Kakkar.

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
Follow up: Dr. Kakkar S. 10 hours later
sent photos to your attention. Thanks! I think I have drug induced SLE secondary to lipitor with high levels of anti-dsDNA levels low positive
ANA and elevated ESR and CRP at times. Symptoms of that have been muscle and joint pain, stiffness and generalized fatigue all relieved with 10-40 mg prednisone daily. Now on 10mg per day and trying to taper. The rheumatologists gave me no answer but that I did not have SLE but I think they are all wrong.
Answered by Dr. Kakkar S. 3 hours later
Brief Answer:
Seborrheic dermatitis

Detailed Answer:
I have viewed the images.
I think you have seborrheic dermatitis. I can see yellowish/ greasy looking scale and erythema of the scalp.
I suggest you to use a Ketoconazole based shampoo e.g Nizoral or Nizral shampoo. Lather it well on to wet scalp and allow it to act for 7-10 minutes before rinsing it off. Use daily.
In addition to this I suggest you to apply a topical steroid lotion e.g Mometasone furoate lotion, twice daily.
Anti ds DNA is a specific marker for SLE.

Hope I have answered your query.
Take care
Dr. Kakkar S
Above answer was peer-reviewed by : Dr. Kampana

The User accepted the expert's answer

Share on