Scalp psoriasis has a significant psychosocial impact on individuals affecting their quality of life. It occurs in 50-80% of patients with psoriasis and may be the only affected area of the body. Current topical therapies for scalp psoriasis are difficult or unpleasant to apply, resulting in decreased adherence and efficacy. A combination of calcipotriol and betamethasone dipropionate in a gel formulation has been developed and approved in Germany for the treatment of scalp psoriasis. Multiple randomized controlled clinical trials have confirmed the efficacy and safety of the new formulation. After two weeks, 60% of patients showed significant improvement; this climbed to 70%, after eight weeks. It may be safely used for up to 52 weeks. No cases of atrophy, striae, or steroid purpura were noted in two 52-week studies. Although scalp psoriasis can often be adequately treated with topical therapy, there is a need for treatment recommendations and algorithms for severe forms and for patients with extended body involvement, taking the combination of systemic and topical treatment and the presence of comorbidities into account.
