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While it is difficult to determine the most effective biologic or small molecule in the treatment of scalp psoriasis because of varying differences in outcome measures and lack of head-to-head studies, guselkumab, infliximab, ixekizumab, and brodalumab appear, on average, to have the highest efficacy in the clearance of scalp psoriasis across studies (Table 1)

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Serious side effects include muscle weakness, extreme thirst, confusion, shortness of breath, headache, exhaustion, reddening of the skin, and a fast or irregular heartbeat