Scalp Dermatology

Question 1

Dandruff presentation…..

Answer 1

Minimal Inflammation –> Dry powdery scales

Question 2

Seborrhea presentation….

Answer 2

Inflammation –> Yellow oily greasy scales

Question 3

What is the etiology of dandruff?

Answer 3

Yeast-like / fungal organisms

Question 4

Dandruff is accelerated when….

Answer 4

-Accelerated by puberty (androgens)

Question 5

Dandruff is worse in…..

Answer 5

• Males
• Stress
• HIV
• Psoriasis

Question 6

Dandruff has a ____ component

Answer 6

Genetic

Question 7

Dandruff Differentials

Answer 7

a) Tinea –> One spot whereas dandruff all over scalp
b) Psoriasis –> Common on scalp

Question 8

Tx of dandruff

Answer 8

• Non-medicated shampoo

Question 9

What are the types of OTC shampoo? What are their uses?

Answer 9

Salicyclic Acid - Keratolytic

Coal Tar - Cytostatic

Selenium Sulfide - Cytostatic and anti-fungal

Zinc Pyrithione –> Cytostatic and anti-fungal

Ketoconazole –> Cytostatic and anti-fungal

Ciclopirox –> Cytostatic and anti-fungal

Question 10

What are the key aspects/counselling tips for dandruff shampoo’s?

Answer 10

-Tx the scalp, not the hair

Question 11

Dandruff Shampoo Duration

Answer 11

Generally used 2x per week

Question 12

Topical Scalp Steroids Used when….

Answer 12

Not generally for dandruff; more for seborrhea

Question 13

Seborrhea/Seborrheic Dermatitis Presentation

Answer 13

-Yellowish scales, possible some redness, more often in males

Question 14

Where on the body does seborrhea occur?

Answer 14

• Chest, scalp, underarms, genitals

Question 15

In woman who present with seborrhea type lesions, one should consider_____ because…..

Answer 15

Perioral Dermatitis

Occurs more in woman

Question 16

If lesions on the scalp, a pharmacist should….

Answer 16

Refer to MD

• Scalp is hard to penetrate with OTC products

Question 17

What are some differentials of seborrhea?

Answer 17

• Ecezma, psoriasis
• Tinea corporis
• Perioral dermatitis –> woman
• Rosacea –> mainly on face

Question 18

Seborrhea Tx

Answer 18

• Mainly via MD
• Apply agent to affected areas
• Tar shampoos –> OTC

Antifungal product:
Ketoconazole top 2% crm OD-BID x 4 weeks

Ciclopirox shampoo

Topical steroids –> Just redness; not fungus

Pimecrolimus crm –> RX –>anti-inflammatory non-steroidal –> just redness