Scalp Examination

 

Scalp examination

Inspection

Palpation

Lump

  • Number
  • Site
  • Shape
  • Size
  • Surface

Skin and color   Alopecia

  • Special signs

Pulsations Metastasis

Cirsoid aneurysm

Impulse on cough Meningiocele

Transillumination

  • Relations to the surroundings .. Mobility
  • Relation to skin
  • Relation to muscles
  • Relation to bone
  • Other swellings
  • Temperature
  • Tenderness
  • Edge
  • Reducibility
  • Solid, fluid or gas
  • Consistence
  • Fluctuation
Ulcer (as any ulcer)
Differential diagnosis of scalp disorders
  • Traumatic
    • Heamatomas
    • Cephalhaematoma
  • Sebaceous cyst
  • Neoplastic
    • Benign
      • Ivory osteoma
      • Lipoma
      • Haemangioma (capillary, cavernous and arterial)
      • Neurofibroma
    • Malignant
      • Primary
        • Basal cell carcinoma
        • Squamous cell carcinoma
        • Malignant melanoma
        • Leukaemia
        • Myeloma
      • Secondary
        • Breast
        • Bronchus
        • Thyroid
        • Prostate
        • Kidney
  • Infective
    • Cock’s peculiar tumor
    • Tinea capitis
    • Abscess
  • Others
    • Psoriasis
    • Seborrhoeic dermatitis
    • Meningiocele
    • Dermoid cyst

Anatomical Significance

 SCALP Layer Content Surgical importance
S Skin Hair follicles
  • Alopecia
  • Sebaceous Cyst
  • If multiple Turban
C CT Blood vessels
  • Bleeds a lot
  • Good healing
  • Site of heamatomas
nerves Layer of local anesthesia
Fibrous tissue septa Heamatoma will be localized
A Aponeurosis
L Loose areolar tissue Loose
  • Dangerous
  • Spread of infection
  • Mobile Cutaneous swelling
  • Layer of descalping
Emissary veins
P Periosteum