How can clinicians tell the difference between seborrheic dermatitis and scalp psoriasis?—VICTOR CZERKASIJ, FNP-C, APRN-BC, Cleveland, Tenn.

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When there are other clinical stigmata of psoriasis (e.g., disease-associated cutaneous plaques or nail changes), the same diagnosis for the accompanying scalp lesions would likely be favored. However, differentiating severe seborrheic dermatitis from psoriasis localized only to the scalp can be clinically challenging and perhaps not always possible. Some consider these entities as endpoints of a disease spectrum and include sebopsoriasis as a diagnosis whose clinical features fall between the two conditions. — Philip R. Cohen, MD (155-6)