Yes good followup still pt needs to continue the treatment and followup
Treatment for seborrheic dermatitis focuses on loosening scale, reducing inflammation and swelling, and curbing itch. In mild cases, a topical antifungal cream or medicated shampoo (such as ketoconazole, selenium sulfide, coal tar, and zinc pyrithione) may be enough to control symptoms.
Sebhorric dermatitis Clop s nano gel locally Tab Medrol 8 mg b d Tab Levocet 1 bd
Rx kerotop shampoo twice in a week Apply KEROTOP spray Levosiz m Ivepred
GOOD IMPROVEMENT.. NEED'S TO CONTINUE.. WITH TIME TO TIME FOLLOW UP..
Yes Seborric dermatitis Responded to treatment Continue
Excellant results.continue same tt further for 15 days.
Good improvements but continue treatment
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8 yr boy with generalized scaling skin lesions involving whole body, with scalp , with itching , with fever on and off x 1 month.no lesion on palm and normal nails..shown to some local quack.. given ketoconazole shampoo , omnacortil, multiple antibiotics linozolid , augmentin, taximo , inj amika , with acivir oint as well in last 1 month .. kindly give possible diagnosis..Dr. Rakesh Yadav4 Likes27 Answers
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Friends today again I am discussing about a skin. Problem known as Seborrhoeic dermatitis. What is seborrhoeic dermatitis? Seborrhoeic dermatitis is a common, chronic or relapsing form of eczema/dermatitis that mainly affects the sebaceous, gland-rich regions of the scalp, face, and trunk . There are infantile and adult forms of seborrhoeic dermatitis. It is sometimes associated with psoriasis (sebopsoriasis). Seborrhoeic dermatitis is also known as seborrhoeic eczema. Dandruff (also called ‘pityriasis capitis’) is an uninflamed form of seborrhoeic dermatitis. Dandruff presents as bran-like scaly patches scattered within hair-bearing areas of the scalp. What causes seborrhoeic dermatitis? The cause of seborrhoeic dermatitis is not completely understood. It is associated with proliferation of various species of the skin commensal Malassezia, in its yeast (non-pathogenic) form. Its metabolites (such as the fatty acids oleic acid, malssezin, and indole-3-carbaldehyde) may cause an inflammatory reaction. Differences in skin barrier lipid content and function may account for individual presentations. Who gets seborrhoeic dermatitis? Infantile seborrhoeic dermatitis affects babies under the age of 3 months and usually resolves by 6–12 months of age. Adult seborrhoeic dermatitis tends to begin in late adolescence. Prevalence is greatest in young adults and in the elderly. It is more common in males than in females. The following factors are sometimes associated with severe adult seborrhoeic dermatitis: Oily skin (seborrhoea) Familial tendency to seborrhoeic dermatitis or a family history of psoriasis Immunosuppression: organ transplant recipient, human immunodeficiency virus (HIV) infection and patients with lymphoma Neurological and psychiatric diseases: Parkinson disease, tardive dyskinesia, depression, epilepsy, facial nerve palsy, spinal cord injury and congenital disorders such as Down syndrome Treatment for psoriasis with psoralen and ultraviolet A (PUVA) therapy Lack of sleep, and stressful events. What are the clinical features of seborrhoeic dermatitis? Infantile seborrhoeic dermatitis Infantile seborrhoeic dermatitis causes cradle cap (diffuse, greasy scaling on scalp). The rash may spread to affect armpit and groin folds (a type of napkin dermatitis). There are salmon-pink patches that may flake or peel. It is not especially itchy, so the baby often appears undisturbed by the rash, even when generalised. Infantile seborrhoeic dermatitis Adult seborrhoeic dermatitis Seborrhoeic dermatitis affects scalp, face (creases around the nose, behind ears, within eyebrows) and upper trunk. Typical features include: Winter flares, improving in summer following sun exposure Minimal itch most of the time Combination oily and dry mid-facial skin Ill-defined localised scaly patches or diffuse scale in the scalp Blepharitis: scaly red eyelid margins Salmon-pink, thin, scaly, and ill-defined plaques in skin folds on both sides of the face Petal or ring-shaped flaky patches on hair-line and on anterior chest Rash in armpits, under the breasts, in the groin folds and genital creases Superficial folliculitis (inflamed hair follicles) on cheeks and upper trunk Extensive seborrhoeic dermatitis affecting scalp, neck and trunk is sometimes called pityriasiform seborrhoeide. How is seborrhoeic dermatitis diagnosed? Seborrhoeic dermatitis is diagnosed by its clinical appearance and behaviour. As malassezia are a normal component of skin flora, their presence on microscopy of skin scrapings is not diagnostic. Skin biopsy may be helpful but is rarely indicated. Histological findings specific to seborrhoeic dermatitis are superficial perivascular and perifollicular inflammatory infiltrates, psoriasiform hyperplasia, and parakeratosis around follicular openings. What is the treatment for seborrhoeic dermatitis? Treatment of seborrhoeic dermatitis often involves several of the following options. Keratolytics can be used to remove scale when necessary, eg salicylic acid, lactic acid, urea, propylene glycol Topical antifungal agents are applied to reduce malassezia eg ketoconazole, or ciclopirox shampoo or and/or cream. Note, some strains of malassezia are resistant to azole antifungals. Try zinc pyrithione or selenium sulphide Mild topical corticosteroids are prescribed for 1–3 weeks to reduce the inflammation of an acute flare Topical calcineurin inhibitors (pimecrolimus cream, tacrolimus ointment) are indicated if topical corticosteroids are often needed, as they have fewer adverse effects on facial skin. In resistant cases in adults, oral itraconazole, tetracycline antibiotics or phototherapy may be recommended. Low dose oral isotretinoin has also been shown to be effective for severe or moderate seborrhoeic dermatitis. Scalp treatment Medicated shampoos containing ketoconazole, ciclopirox, selenium sulfide, zinc pyrithione, coal tar, and salicylic acid, used twice weekly for at least a month and if necessary, indefinitely. Steroid scalp applications reduce itching, and should be applied daily for a few days every so often. Calcineurin inhibitors such as tacrolimus can be used as steroid alternatives. Coal tar cream can be applied to scaling areas and removed several hours later by shampooing. Combination therapy is often advisable. Face, ears, chest and back Cleanse the affected skin thoroughly once or twice each day using a non-soap cleanser. Apply ketoconazole or ciclopirox cream once daily for 2 to 4 weeks, repeated as necessary. Hydrocortisone cream can also be used, applied up to twice daily for 1 or 2 weeks. Occasionally a more potent topical steroid may be prescribed. Topical calcineurin inhibitors such as pimecrolimus cream or tacrolimus ointment may be used instead of topical steroids. A variety of herbal remedies are commonly used, but their efficacy is uncertain. Management in infants Regular washing of the scalp with baby shampoo or aqueous cream is followed by gentle brushing to clear the scales. GRAPHITES 30-Graphites is an effective Homeopathic medicine for seborrheic dermatitis where the scales on the scalp are accompanied by intense itching. ... NATRUM MURIATICUM 30- Natrum Muriaticum is prescribed for seborrheic dermatitis with a greasy, oily scalp with redness and flakiness. Other homoeopathic medicines can also be given on the basis of totality of symptoms.Dr. Rajesh Gupta9 Likes15 Answers
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*Dandruff* ☝today☝ It is a skin condition that makes itchiness and affects mainly the scalp. Dandruff is also known as ‘seborrheic dermatitis’ which is the extreme form of the condition includes inflammation of the skin. This cause top layer of the skin gets damaged with scalp starts to broken out. Top layer controls the dead cells that protect more brittle cells below. Flaking of dead skin is a part of the regular process where dead skin cells drop with a new layer formulated below. However, certain factors makes inordinate flaking of the skin. Dandruff can be really embarrassing and irritating to deal with. And the worst thing about dandruff is that it may cause acne and mess up with skin too. The dandruff flake is either dry or greasy. It affects the strength of your hair and leads them to hair fall. Types Dandruff can be of following types: Dry Skin-Related Dandruff: Dandruff that occurs because of dry skin is a very common type. Generally, during winters, when you wash your hair with warm water, it becomes more dry and flaky. Oil-Related Dandruff: It is also a common cause of dandruff in which sebum or oil secreted from the scalp gets accumulated on the skin. It happens as a result of sporadic or improper washing of hair. If the scalp is unclean, sebum or skin oil gels with all the dead skin cells and dirt, giving itchy flakes. Fungal Dandruff: Malassezia is a fungus present on the scalp and skin. Generally, its growth is limited, but when there is excessive oil on the scalp, it favors the growth of this fungus. Malassezia gives oleic acid as a byproduct. This acid produces a lot of dead skin cells, causing white flakes. Disease-Related Dandruff: Some conditions like psoriasis lead to excess production of dead skin cells that result in the scaly skin. Skin cells combine with dirt and sebum to cause dandruff. Eczema also makes skin flaky and itchy and may contribute to the formation of dandruff. Risk factors It is clear that dandruff is not really dangerous and is pretty harmless but there are risk factors that may make some people more susceptible to dandruff than others. Age Dandruff is more common in young adults up to those who are middle-aged. Older adults may also get dandruff and for some, it could be lifelong. Being Male Men are also more susceptible to dandruff than women. Some researchers think it’s because of certain hormones in men. Oily Hair and Scalp If you have really oily skin and hair, you are more prone to dandruff. As a final note, certain illnesses are also some of what causes dandruff. Those with neurological diseases like Parkinson’s are more likely to have it as well as those with weakened immune systems. Causes There are several possible causes of dandruff: Seborrheic dermatitis: This is a condition characterized by irritated, oily skin. Skin will appear red and greasy and covered by flaky white or yellow scales. It can affect the scalp and other areas rich in oil glands, including the eyebrows, sides of the nose, backs of the ears, breastbone, groin area and sometimes the armpits. Malassezia: This is a yeast-like fungus that lives on the scalp of most adults. In some cases, it will irritate the scalp and create more skin cell growth. These new cells die and fall off, and create white dandruff flakes. Not shampooing enough: Oils and skin cells from the scalp build up over time if you don’t wash your hair often enough, which causes dandruff. Dry skin: Flakes from dry skin are typically smaller and less oily than those from other causes, and redness or inflammation is unlikely. In these cases, dry skin is likely more noticeable on other areas of the body besides the scalp, as well. Contact dermatitis: This is sensitivity to certain ingredients in hair care products. It can cause a red, itchy, scaly scalp. Symptoms Dermatologists commonly refer to dandruff as seborrhea or seborrheic dermatitis. The signs and symptoms include: White flakes on shoulders of dark clothing Itchy scalp Scaly facial skin Recurrent ear “eczema” Facial rash over eyebrows, nose, and ears Oily scalp and facial skin with dry flakes Eyebrow rash Beard rash Chest rash with dry flakes and red spots Symptom of dandruff Complications It is very unusual for complications to develop as a result of dandruff and seborrhoeic dermatitis. The most likely complication is an adverse reaction to any treatments you may be using. If a product irritates your scalp, stop using it immediately. Your GP or pharmacist can recommend a more suitable alternative. It is possible for dandruff or seborrhoeic dermatitis to cause an infection if a germ enters a break in your skin or scalp. Contact your GP if your dandruff does not improve after using over-the-counter medicated shampoos, or if your scalp becomes swollen and red. Also contact your GP if you have seborrhoeic dermatitis that does not respond to treatment, or if you experience any of the following: The patches of seborrhoeic dermatitis contain fluid or pus Crusts form on the patches of seborrhoeic dermatitis The patches of seborrhoeic dermatitis become red or very painful Although dandruff and seborrhoeic dermatitis are not signs of poor hygiene, they can sometimes cause psychological distress and affect a person’s self-esteem. Diagnosis and test Dandruff is generally fairly easy to diagnose. A medical professional can usually identify dandruff by looking at the rash and asking questions about how it appeared. In rare instances, highly atypical cases may require more exams and tests including skin scrapings for, microscopic evaluation, and skin biopsies. A healthcare practitioner may scrape some scales off the rash and look at them under the microscope to make sure the rash is not caused by a fungus. A very small piece of skin may be taken (a biopsy) for microscopic examination to exclude other causes like psoriasis, lupus, and other skin diseases. Treatment Dandruff, in most cases, can be controlled. In cases of mild dandruff, cleaning the head daily with a gentle shampoo for reducing oil and buildup or growth of excessive skin cells may be helpful. There are dandruff shampoos available depending on the medications they contain. Pyrithione Zinc Shampoos: These shampoos contain antifungal and antibacterial agent – zinc pyrithione. This type of shampoo reduces fungus on the scalp that results in dandruff. Tar-Based Shampoos: Coal tar helps in reducing dandruff as it slows down the rate of the death of skin cells that causes flakiness. For light colored hair, this shampoo may lead to discoloration. Salicylic Acid-Based Shampoos: Shampoos containing salicylic acid helps get rid of the scale. However, it leaves the scalp dry, which further causes more flakiness. Using a conditioner after shampooing can be beneficial. Shampoos Containing Selenium Sulfide: These shampoos slow down the rate at which skin cells dry and may also reduce the fungus, Malassezia. Ketoconazole Shampoos: It is an antifungal agent, which generally works when other shampoos have failed. It is available over the counter (OTC) and also as the prescription. Apply these shampoos often or every day till the time your hair becomes completely free of dandruff. Once the dandruff is gone, one can still use these shampoos twice or thrice a week. If you have religiously shampooed for many weeks, but still have not found any relief, then you must consult a doctor or dermatologist, who may suggest you a prescription-strength shampoo or treatment with the steroid lotion. Antidandruff shampoos Natural treatment Some simple and natural remedies for treating dandruff are given below: Natural treatment for dandruff Coconut Oil and Lemon Massage: Coconut oil nourishes the scalp and at the same time, lemon juice treats dandruff without the involvement of any harmful chemical. Heat about 2 tablespoons of coconut oil and mix it with an equal amount of lemon juice. Gently massage your scalp with the mixture. Let it stay for 20 minutes before you rinse it off. Fenugreek Pack: Soak fenugreek in water overnight. Mash the soaked fenugreek in a paste and remove the water. Apply the paste for about half an hour and then, rinse it off with a shampoo. Curd: Applying curd could be cumbersome, but it is highly effective in treating dandruff. Apply curd to your hair strands and let it remain for half an hour before you rinse it off with a shampoo. Baking Soda: It has also been used as an effective treatment for dandruff. Slightly wet your hair and apply baking soda. Leave it on for about two to three minutes and then, washing it off. Tea Tree Oil: It is highly effective in treating dandruff. Put a few drops of tea tree oil and spread it evenly across the scalp. Let the scalp soak it for five minutes. Then, rinse it off with a shampoo. Apple Cider Vinegar: Mix apple cider vinegar with equal an amount of water and after having a hair wash, apply the mixture on the wet hair. Massage your scalp and let it remain for 15 minutes before washing it off. Neem Juice: Neem has anti-bacterial properties. One can grind a bunch of neem leaves to form a thick paste. Apply it on the scalp for 10 minutes and wash it off with water. Orange Peel Pack: Take some orange peel and squeeze some lemon juice in it. Grind it into a paste and apply it for half an hour. Then, wash it off with a shampoo. Prevention One may use an antifungal or anti-dandruff shampoo once a week. This may help prevent dandruff. Also, spend time in the sun, but in the limit as too much exposure to the sun may have damaging effects on the skin. Dandruff is more severe in the winter months, so the best way to increase humidity is to buy humidifiers. Make sure humidifier is clean before you use it. Reduce stress as stress aggravates dandruff. Stress may trigger or worsen the condition of dandruff. A little modification in one’s diet can also be beneficial. When it comes to dandruff, foods containing zinc, omega-3 fatty acids, and vitamin B may be beneficial.Dr. Shailendra Kawtikwar7 Likes8 Answers
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68 year Male, itching and pricking sensation over the mustache area since 30 years.. given history of powdery while rubbing on it. marked white patch after washing the face and burning. His BP normal and not known diabetic. what is the diagnosis? and treatment.?Dr. P.kishore Kumar2 Likes27 Answers
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Itching multiple scaly lesions throughout the body with fever Loss of appetite, constipation since 2 days . Urine colour is red . Investigations not done What is your diagnosis on appearance?Dr. P.kishore Kumar1 Like32 Answers