Case from Dr Ian McColl
The case of seborrhoeic dermatitis illustrated here shows large patch areas on the cheeks, sometimes called a petaloid pattern, although the latter is more commonly seen on the anterior chest wall. The condition on the face is best treated with some Nizoral (Ketoconazole) cream with a weak topical corticosteroid such as 1% hydrocortisone cream applied at night for persisting inflammation.
5 comments:
What do you do with the case of seborrhoeic dermatitis that does not respond to topical antifungals? You have to be careful about using a strong topical steroid which in the end will simply induce rosacea.
This is disease with remission and exaberbations.If risky behaviour ,I rule out HIV.What about tacrolimus?But I have not tried it.
Kiran Nabar
I have had good experience with topical miconazole plus hydrocortisone and ketoconazole shampoo. In resistent cases, I use oral ketoconazole.
I notice there is more in the literature on the use of Pimecrolimus cream in treating seborrhoeic dermatitis than Tacrolimus. Pimecrolimus seems to work and the improvement is sustained longer than if a topical steroid is used. It can cause some facial irritation though. Tacrolimus would probably be more irritating.
In young males with severe seborrhoeic dermatitis ruling out HIV is a wise move.In the early phase of the AIDs epidemic this was a common presentation of the disease. Now that patients get effective anti aids drugs early, severe seborrhoeic dermatitis in this group is much less common.
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