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Scalp dysesthesia (SD) presents with abnormal scalp sensations in the absence of an underlying primary dermatologic disorder. Initially attributed to psychiatric disorders, 1 SD symptoms were subsequently described in association with underlying cervical degenerative disc disease with compensatory accessory neck muscle tension on the occiptofrontalis muscle/scalp aponeurosis. 2 The proposed mechanism is akin to notalgia/meralgia paresthetica.

After institutional review board approval, we performed a detailed retrospective chart review of a cohort of patients with SD and cervical spine imaging results at a single, academic outpatient medical dermatology clinic from 2013 to 2018. A total of 65 patients were identified (Table I). Notably, 21.5% of patients presented with concurrent telogen effluvium, 4.6% with excoriations, and 3.8% with trichotillomania. Cervical spine x-ray films were obtained on 62 patients, of …