<p class="abstract"><strong>Background:</strong> The optimal treatment guidelines for psoriasis using biologics are limited. In addition to this, the administration of the original biologic may be terminated or switched to another biologic due to inefficacy, adverse effects, and economic burden. Our objective is to compare demographic characteristics between switched and non-switched groups and to identify the reason for switching among various original biologics in our setup.</p><p class="abstract"><strong>Methods:</strong> We performed a retrospective cohort analysis of psoriatic patients on biologic treatment. Our analysis involved 42 patients, of which 19 were switched to the second biologic. The demographic characteristics and reason for biologic switching were noted and data analyzed between switched and non-switched groups.<strong></strong></p><p class="abstract"><strong>Results:</strong> First line therapies were infliximab (IFX, n=10), etanercept (ETN, n=21), secukinumab (SEC, n=11) and switching required in 3 (30%), 11 (52%), 5 (45%) patients respectively. The reason for switching, in general, in our setup is inefficacy (n=10; 53%), non-availability (n=8; 42%) and adverse event (n=1; 5%). Small number of patients, single-centre study and retrospective design were the limitations.</p><p class="abstract"><strong>Conclusions:</strong> Infliximab showed the least tendency to switch to the second biologic, however, it had adverse reactions. Inefficacy is the primary cause of switching. To the best of our knowledge, our study on Biologics switching is the first of its kind in the Indian scenario.</p>

is a common disorder in Children that includes atopic dermatitis, seborrheic dermatitis, tinea capitis, and psoriasis. 1 In a survey of 735 adults in the United States, 39% experienced some flaking, and almost 50% complained of scalp itch. 2In human societies, hair and scalp now play an important role in appearance and sexual signalling; original functional roles of protection and heat conservation are secondary, and changes in the appearance of skin and hair, which affect self-esteem and confidence in social settings, have become primary. The good condition of the scalp has a considerable effect on the patient's psychological well-being and social interaction. The ABSTRACTBackground: The scalp is unique among skin areas in humans, with high follicular density and high rate of sebum production which though providing thermal insulation also creates an environment conducive to superficial mycotic infections and parasitic infestations. As there is a paucity of studies on scalp dermatoses in the Indian and Western literature, a clinical study of these scalp dermatoses can unravel the common clinico-epidemiological manifestations in our population. Methods: This is a prospective observational study conducted for a period of 6 months. All the patients reporting to our department were evaluated for entry into the study and patients having scalp lesions were enrolled. A detailed clinical history and a thorough scalp examination were performed. Results: The incidence of scalp dermatoses is more among adolescents and early adulthood with a male to female ratio 1.8:1. 57% of patients had lesions exclusive to scalp. Scalp was the initial site of presentation in 54.6% of cases who had generalized lesions. Itching (n=107; 53.5%) is the commonest presenting complaint. Among the scalp sites, parietal area was involved the most (73%). The most common dermatoses were psoriasis (21.5%) followed by alopecia areata (11.5%). Conclusions: The scalp dermatoses have significant psychological impact affecting the social profile of the patients. To the best of our knowledge, this is the first Indian study on scalp dermatoses involving all age groups which gives a precise clinical insight into scalp dermatoses.