Differential Diagnosis for Dry, Flaky, Sometimes Painful Red Scalp

• Single Most Likely Diagnosis
  • Seborrheic dermatitis: This condition is characterized by a red, itchy, and flaky scalp, often accompanied by inflammation. It's a common condition that matches the symptoms described.
• Other Likely Diagnoses
  • Psoriasis: This autoimmune condition can cause red, scaly patches on the scalp, which may be painful and itchy. The symptoms can vary in severity.
  • Dandruff: A mild form of seborrheic dermatitis, dandruff causes flakes of skin to appear on the scalp, often with itchiness but less commonly with pain.
  • Eczema (atopic dermatitis): This condition can affect the scalp, leading to dryness, flakiness, and redness, often with itchiness and sometimes pain.
• Do Not Miss Diagnoses
  • Lupus: Systemic lupus erythematosus can cause scalp lesions that are painful and lead to scarring. Although less common, missing this diagnosis could have significant consequences.
  • Sarcoidosis: This condition can cause skin lesions and rashes, including on the scalp, which might be painful and could lead to more serious health issues if not addressed.
  • Infections (bacterial, fungal, or viral): Certain infections can cause painful, red, and flaky scalp conditions. Identifying and treating the underlying infection is crucial.
• Rare Diagnoses
  • Pityriasis amiantacea: A rare condition characterized by thick, yellow scales on the scalp, which can be associated with psoriasis or seborrheic dermatitis.
  • Lichen planus: An inflammatory condition that can affect the skin and mucous membranes, sometimes causing lesions on the scalp that are painful and itchy.
  • Discoid lupus erythematosus: A chronic skin condition of sores with inflammation and scarring favoring the face, ears, and scalp but can be limited to the scalp, leading to hair loss.