Seborrheic dermatitis

Lipophilic yeasts from Malassezia genus has been implicated in the development of this disorder

• Pityrosporum ovale

Often associated with acne rosacea

Rx

•  reduce inflammation/Rx discomfort
• 1% HC cream tds for face/axilla/groin
• or Advantan or Elocon for first 5-7 days
• remove scale
• 3% sulfur + 3% salicylic acid in emulsifying ung or similar keratolytic
• tar-based product
• target Malassezia
• Hyrdrozole cream (1% HC + 1% clotrimazole)
• Nizoral cream (ketoconazole)
• Selsun shampoo (for scalp and body)

For recalcitrant or severe disease

--> oral azole e.g. ketoconazole (daily for 1/52); fluconazole (weekly for 2/52)

--> isotretinoin