seb derm Flashcards
genedee r
male
DP
Focal parakeratosis, with ew neutrophils, moderate acanthosis, spon- giosis(intercellularedema),andnonspeci c
in ammationo thedermis.Neutrophilsatthe tipso thedilated ollicularopenings,which appear as crusts/scales
tx
SCALP Adults. Shampooscontainingselenium sul de,zincpyrithione,and/ortar.2%keto- conazoleshampooisverye ective;lathercan beusedon aceandchestduringshower.Low- potencyglucocorticoidsolution,lotion,orgels
ollowing a medicated shampoo (ketoconazole or tar) or more severe cases. Pimecrolimus, 1% cream,isverybene cial.
Infants. For cradle cap, removal o crusts with warm olive oil compresses, ollowed by baby
shampoo, 2% ketoconazole shampoo, and applicationo 1to2.5%hydrocortisonecream, 2% ketoconazole cream, and 1% pimecrolimus cream.
FACEANDTRUNK Ketoconazoleshampoo,2%. Glucocorticoid cream and lotions. 2% keto- conazole cream, 1% pimecrolimus cream, and 0.03% or 0.1% tacrolimus ointment.
EYELIDS Gentleremovalo thecrustsinthe morning with a cotton ball dipped in diluted baby shampoo. Sodium sul acetamide in a suspension containing 0.2% prednisolone and 0.12% phenylephrine. Sodium sul acetamide ointmentaloneisalsoe ective,asis2%keto- conazole cream, 1% pimecrolimus cream, or 0.03% tacrolimus ointment. INTERTRIGINOUSAREAS Ketoconazole,2%. I uncontrolled with these treatments, Castel- lani paint or dermatitis o the body olds is ofenverye ective,butstainingisaproblem. Pimecrolimus cream, 1%; tacrolimus ointment, 0.03% or 0.1%.
SystemicTherapy
In severe cases, 13-cis-retinoic acid orally, 0.5 to 1 mg/kg, is highly e ective. Contraception should be used in emales o childbearing age. In milder cases, itraconazole 100 mg twice daily on two consecutive days, once a month, ise ective.
Maintenance Therapy
Ketoconazole2%shampoo,tarshampoos, andketoconazolecreamaree ective.1to 2.5% hydrocortisone cream daily will work, but patients should be monitored or signs o atrophy;1%pimecrolimuscreamand0.03% tacrolimus ointment are also sa e and
e ective.
