Visibility of head and neck Psoriasis has a considerable impact on patients’ QOL. The differential diagnosis for pustular skin disorders is extensive but facial Psoriasis more commonly affects eyebrows, the skin between the nose and the upper lip, the upper forehead and the hairline. Scalp Psoriasis is very common. Multiple instruments have been used to determine the severity of scalp Psoriasis and tools for patient self-assessment have also been developed (Psoriasis Area and Severity Index or PASI, Psoriasis Scalp Severity Index or PSSI, Body Surface Area or BSA, Physicians' Global Assessment or PGA, Lattice Physician Global Assessment or LS-PGA, and Self-assessed Psoriasis Area and Severity Index or SAPASI) but none of the severity scores used for Psoriasis meets all of the validation criteria required for an ideal score.
Phototherapy (light therapy) for psoriasis on neck
The ultraviolet (UV) light from the sun slows the production of skin cells and reduces inflammation. Sunlight helps reduce psoriasis symptoms in many people. If psoriasis is so widespread that topical therapy is impractical, then artificial light therapy may be used. Proper facilities are required for the two main forms of light therapy. The medical light source in a physician's office is not the same as the light sources generally found in tanning salons, which are of limited use for psoriasis. It must be remembered that all UV radiation has a potential to cause mutations and skin cancers. Although the incubation period for these skin cancers is quite long, UV exposures should be carefully monitored.
UV-B: Ultraviolet B (UV-B) light is used to treat psoriasis. UV-B is light with wavelengths of 290-320 nanometers (nm). Within the last 10 years, a new form of UV therapy called narrow-band UV-B (NBUVB) has become available which seems to be very effective with less burning potential than conventional broadband UV-B. It presumably contains the most therapeutic wavelengths and avoids the more toxic ones. (The visible light range is 400 nm-700 nm.) UV-B therapy is usually combined with one or more topical treatments. UV-B phototherapy is extremely effective for treating moderate-to-severe plaque psoriasis. The major drawbacks of this therapy are the time commitment required for treatments and the accessibility of UV-B equipment.
The Goeckerman regimen uses coal tar followed by UV-B exposure and has been shown to cause remission in more than 80% of patients. Patients often complain of the strong odor when coal tar is added, and it stains clothing, towels, and sheets.
UV-B therapy can be combined with the topical application of corticosteroids, calcipotriene (Dovonex), tazarotene (Tazorac), or creams or ointments that soothe and soften the skin.
