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The scalp is characterized by a high density of sweat glands and pilosebaceous units consisting of hair follicles, sebaceous glands, and arrector pili muscles. It is estimated that there are some 100,000 follicles on the scalp so this also means that there are about 100,000 sebaceous glands and associated arrector pili muscles.

Skin diseases involving the scalp can be broadly classified into inflammatory dermatoses, infections, and neoplastic (see Table 30-1). Hair on the scalp protects the skin from ultraviolet light and if absent or decreased, predisposes balding individuals to sunburns, photodamage, and photosensitivity. Likewise, the presence of hair may make cleaning the scalp surface with shampoos challenging permitting the development of scalp conditions such as dandruff and seborrheic dermatitis related to colonization of commensal Malassezia yeasts.

Table 30-1.Differential diagnosis for skin diseases of the scalp.

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