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Seborrheic Dermatitis

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Seborrheic Dermatitis

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May be related to skin-surface yeasts (Malassezia furfur) and environmental factors Erythematous scaly plaques on the central face, scalp, behind ears

Can be pruritic

Can affect sternum, axillae, and genital region
More severe, atypical, and diffuse in patients with low CD4 count nadirs

Common in patients who are not on ART: up to 40% of HIV-infected patients and 80% of AIDS patients have seborrheic dermatitis

Should improve with immune reconstitution on ART
Hydrocortisone 1% ointment mixed with ketoconazole or econazole applied BID to affected area

If very itchy: triamcinolone 0.5% ointment in nonfacial areas

Scalp: ketoconazole, tar (T-Gel), selenium sulfide (Selsun), or zinc pyrithione (eg, Head & Shoulders) shampoo twice weekly; leave lather on for 5 minutes before rinsing

From Dermatologic Conditions
Primary Care of Veterans with HIV
Office of Clinical Public Health Programs
Veterans Health Administration, 2009