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Have lesion on scalp. Not cured by dipsalic, steroids and clobetasol. Any effective medication?

Jul 2012
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Answered by

Practicing since : 1993
Answered : 1196 Questions
Dear doctor

My father have lesion (photo attached) over the left side of scalp since 2007. It was treated irregularly initially with dipsalic ointment followed by consultation by dermatologist who also prescribed dipsalic and some anti-allergic drugs. However, this treatment did not improve the condition.

Subsequently another dermatologist was consulted who prescribed some steroids (halox) and blood for XXXXXXX was done which came out negative. About 3 months treatment, this also did not improve the condition.

Another doctor who advised clobetasol with miconazole application on the lesion twice a day. Initially the treatment was irregular but now for about 2 months the medicine is being applied twice a day but it is not healing and has instead increased in size over the years.

In absence of local application of medicine, it starts itching. There are also similar lesions present on legs which are present for about 2-3 years. (photo attached)

Please help me.
Posted Tue, 4 Dec 2012 in Skin Hair and Nails
Answered by Dr. Praveen Rodrigues 1 hour later
Hi there XXXXXXX
Most of your photographs were a touch blurred.
However, going by your history & the images, he does seem to suffer from a benign condition called seborrheic keratoses.
I accept this may not always get better with the topical creams suggested. The only one to my mind that may help would be 5% 5 Fluorouracil cream applied twice/daily on alternate days for about 10 days to 2 weeks under the supervision of a dermatologist.
If the dermatologist is competent, then shave excision using cryotherapy aid may be the way forward to remove the lesion or an excision biopsy or even lasers...basically depending on the particular treating doctor's expertise & available equipment. Dont worry, it is a simple procedure easily done under local anaesthesia in the OPd; costs will depend on the treating facility. If you are anywhere in & around Bangalore, you are welcome to bring your dad to my set-up; if not, please check the XXXXXXX directory for a doctor in your area.
Trust this has calmed you & given you a clear option to make an informed deciscion; would appreciate a closing of the query & a healthy rating , else it keeps bouncing back & forth as a follow-up query. Good Luck & am sure your dad will be rid of this pesky issue. Cheers!
Dr Praveen Rodrigues MD
Dermatologist, Cosmetologist, Venereologist XXXXXXX Hospital, Bangalore, India.
Above answer was peer-reviewed by
Follow-up: Have lesion on scalp. Not cured by dipsalic, steroids and clobetasol. Any effective medication? 26 hours later
Dear doctor

Thanks for your reply.

When you say that he can apply Fluorouracil cream in supervision of a dermatologist, do you think it is XXXXXXX if we start with this cream based on your advice here. Are there any significant side effects of this drug?

He is known case of fatty-liver and GERD. Please let us know if it is okay for him to apply this cream

Answered by Dr. Praveen Rodrigues 16 hours later
Hi there.
This cream is a topical version of an anti-cancer drug & yes it is a freshly prepared cream & if unstable, it may not be a great cream to use in sunlight & it may in some cases lead to a mild darkening of the skin...otherwise no issues but doubt you will get it sans prescription..hence my suggestion of visiting the dermatologist.
Cheers & Godspeed!
Dr Praveen Rodrigues MD
Above answer was peer-reviewed by
Follow-up: Have lesion on scalp. Not cured by dipsalic, steroids and clobetasol. Any effective medication? 26 hours later
Thanks Doctor.

I am a little concerned that it is an anti-cancer drug. Can you please let me know if you are suspecting something serious? Do you mean that this anti-cancer drug will be useful in non-cancerous condition also?

Answered by Dr. Praveen Rodrigues 9 hours later
Yes XXXXXXX the latter..this anticancer drug has been used for more than 2 decades on warts & seborrheic keratoses by me personally also & well documented in literature so no need to worry but as i always say, best to be under the care of a dermatologist nearest you. Cheers!
Dr Praveen Rodrigues MD
Above answer was peer-reviewed by
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