SEBORRHEIC DERMATITIS ======== From: Noola@aol.com What form of ketoconazole have you tried? I have people use the shampoo as liquid soap, 2-3 times per week. Also, I have had 2 such severe cases clear on oral ketoconazole, 200 mg BID for a week, then one 200mg BID dose one day a week as maintenance therapy. Just out of interest, what is the pt's HIV status? ========= From: KSmithDerm@aol.com I have a lady with bad seb derm who responded well when I finally put her on UV-B - I suppose other psoriasis Rx like PUVA or Dovonex might also be helpful [had a boy with bad face psoriasis who cleared up with Dovonex bid to the face, no problems]. ========= Noola@aol.com writes: I have tried topic ketokonazole (cream) BID. The patient is HIV negative. ========== From: MaidaLB@aol.com I use oil soaks of scalp and beard HS (any oil- Baby, Mineral, Wesson) under a shower cap overnight, then wash off in A.M. with Nizoral Shampoo suds for five minutes over two months time, then biweekly maintenance. Works more often than not. =========== From: Haines Ely It would be helpfull to have a bit more information on the patient, ie age. In the younger male AIDS is an exacerbating factor, and in the elderly Parkinson's disease is a factor. I have had elderly patients who were later diagnosed with Parkinson's who initially had intractable seb derm. Patients with seizures may also have seb derm from dilantin or tegritol. Low dose accutane will "cure" almost any seb derm, ie 10mg/day. =========== From: Bill.Lide@ncal.kaiperm.org I have a patient with chronic seborrheic dermatitis in the face, scalp and beard. He has used topic corticosteroids (hydrocortisone 1%), sulfur, salicilic acid, ketokonazole with temporary improvement and later remission of the lesions. If anyone can help, I would like to have opinions about new approaches to this disease. I've had successes with (a) glycolic acid, i.e. AquaGlycolic Shampoo and Body Cleanser, and (b) ZNP Bar. ====================== COMMENTS FROM BILL LIDE I have a paitent with chronic seborrheic dermatitis in the face, scalp and beard. He has used topic corticosteroids (hydrocortisone 1%), sulfur, salicilic acid, ketokonazole with temporary improvement and later remission of the lesions. If anyone can help, I would like to have opinions about new approaches to this disease. I've had successes with (a) glycolic acid, i.e. AquaGlycolic Shampoo and Body Cleanser, and (b) ZNP Bar. ----------------------------------------------- COMMENTS FROM Noola@aol.com What form of ketoconazole have you tried? I have people use the shampoo as liquid soap, 2-3 times per week. Also, I have had 2 such severe cases clear on oral ketoconazole, 200 mg BID for a week, then one 200mg BID dose one daya week as maintenance therapy. Just out of interest, what is the pt's HIV status? ------------------------------------------------ COMMENTS FROM K SMITH, M.D. I have a lady with bad seb derm who responded well when I finally put her on UV-B - I suppose other psoriasis Rx like PUVA or Dovonex might also be helpful [had a boy with bad face psoriasis who cleared up with Dovonex bid to the face, no problems]. ------------------------------------------------- COMMENTS FROM MAIDA BURROW, M.D. I use oil soaks of scalp and beard HS (any oil- Baby, Mineral, Wesson) under a shower cap overnight, then wash off in A.M. with Nizoral Shampoo suds for five minutes over two months time, then biweekly maintenance. Works more often than not. --------------------------------------------------- COMMENTS FROM HAINES ELY, M.D. It would be helpfull to have a bit more information on the patient, ie age. In the younger male AIDS is an exacerbating factor, and in the elderly Parkinson's disease is a factor. I have had elderly patients who were later diagnosed with Parkinson's who initially had intractable seb derm. Patients with seizures may also have seb derm from dilantin or tegritol. Low dose accutane will "cure" almost any seb derm, ie 10mg/day. --------------------------------------------------- I have a patient who develops bright red erythematous plaques of seborrheic dermatitis on his face during times of stress. He frequently uses a low potency corticosteroid for his face and is developing telangiectasias. He has tried metrogel, anti-fungals. Any suggestions? Marty Reichel ------------- I have a lady with bad biopsy-proven seb derm which sometimes responds only to UV-B, which works great for her. KC Smith MD FRCPC ----------------- Another good way to treat recalcitrant seb derm is with a short course of Nizoral PO. Elliot Puritz ------------- I used 1% HC powder & 3% ppt. Sulfur in Nizoral Cr. until I tried Novacet Lotion - my current #1 Rx for Seb derm. GenadijS@aol.com ---------------- You might try 3-5% sulfur 3-5% salicylic acid in clotrimazole cream. This is acompound I use sometimes in people with AIDS and severe seborrheic dermatitis, in whom cortisone is either inappropriate or unwanted by the patient. Warren J. Winkelman, MD, FRCPC ------------------------------ Use Vytone 1%. Are the telangiectasia really from the steroid? Patients with seb derm have naturally red/telangiectatic skin....with or without steroids. Haines Ely ----------