Scalp hyperkeratosis is common in childhood and adolescence. Diagnosis is affected by age, race, and history of infectious exposure, and associated symptoms including atopic features, alopecia, inflammatory nodules, presence and type of cutaneous lesions outside of the scalp, and nuchal lymphadenopathy. Tinea capitis is common in children with skin of color, especially black and Hispanic children. In adolescents, seborrheic dermatitis predominates as the cause of scalp hyperkeratosis, but tinea is still of concern. This article aims to help the practitioner comfortably diagnose and treat scalp hyperkeratosis in children with skin of color.
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