Scalp pustules anyone?
My psoriasis is minimal and kept at bay for the most part with methotrexate. A patch on my arm, and a patch on my nose unfortunately. But I constantly get these pus filled pustules on the back of my head near my hairline. I’ve told my rheumatologist and my PA and they both look at me like hmm… that’s not psoriasis. But I googled that there are indeed psoriatic pustules! Anyone else have these irritating and itchy pustules?
What you describe sounds like folliculitis of the scalp. Are you currently on any DMARDs or biologics for your PsA? Folliculitis is most often caused by an infection of the follicle, and it's a fairly well established side effect of biologics. I had a bout of it when I started Skyrizi, while taking the loading dose. I was prescribed Fluocinonide topical solution along with Clindamycin Phosphate, and it cleared right up. yes I currently take Skyrizi. I’ve been on it for a couple of years now. Before that, I was on Enbrel and it happened then too.
Hi
, sorry to read about these pustules that you're dealing with. You're right that there are psoriatic pustules - here's some information from our sister community for psoriasis on the different types of pustular psoriasis: https://plaquepsoriasis.com/clinical/types-of-pustular-psoriasis I do sometimes get pustules in this area, although I always put that down to not being able to wash my hair as often as I'd like (fatigue !). I'll have to mention this to my doctor next time I see them and see what they say. Now that you've mentioned it, I don't think I've had any pustules since using a coal tar shampoo for my scalp psoriasis.
As Eric mentions, there are other conditions that could be causing these symptoms. I know you mentioned seeing a rheumatologist and a PA, but have you been able to see a dermatologist about this? They would probably be best placed to assess these pustules. It may also be worth asking for a biopsy of the area, which can sometimes help confirm/rule out a diagnosis. Here's some further information on biopsies, if that would be helpful: https://plaquepsoriasis.com/diagnosis-confirm-test-biopsy-rule-out
I hope you'll get some more responses from the community here. Please keep us updated on how you're doing if you can. Hope you can get some answers! Warmly, -Catherine, Community Moderator
