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Dr. Andrew Rynne
MD
Dr. Andrew Rynne

Family Physician

Exp 50 years

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Suggest Treatment For Itchy And Round Skin Rashes

I have a skin problem and so far 8 months and several prescription ointments and creams an oils with no success, it is round red spots that sometimes itches but not that much, then they turn lighter red and become crusty like not scaly or flaky light brown in color, one will go away after weeks of treatment then 4 comes back, my scalp is extremely dry looks like dandruff but not itchy and now i have lost over half my hair i have bald spots, can you help me
Fri, 1 Aug 2014
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Dermatologist 's  Response
Hi,

It seems that you may be having seborrheic dermatitis. There may be flaky patches on chest,axillae and groin areas. There may be dandruff. Seborrheic dermatitis is an inflammatory skin condition. It may be precipitated by factors like stress,anxiety, sleeplessness,Oily skin (seborrhoea),Familial tendency ,
Immunosuppression due to organ transplant, human immunodeficiency virus (HIV) infection and others,Neurological and psychiatric diseases...like Parkinson disease, tardive dyskinesia, depression...etc. Yeast like mellessezia furfur may be associated. You consult dermatologist for firm diagnosis and treatment.

I generally give treatment in my patients having such problem in following way..
-antifungal tablets like ketoconazole with steroid in tappering dose for few weeks.
-antihistaminic like levocetirizine till itch and discomfort is reduced.
- vitamin like folic acid may be taken for long time.
- associated disease may be treated.
-Keratolytics to remove scale used when necessary, eg salicylic acid, lactic acid, urea, propylene glycol
-Topical antifungal agents to reduce Malassezia eg ketoconazole, or ciclopirox cream or zinc pyrithione or selenium sulphide lotion
-Mild topical corticosteroids for 1-3 weeks to reduce inflammation in acute flare like mometasone.
-Topical calcineurin inhibitors (pimecrolimus cream, tacrolimus ointment) as required
- for dandruff, shampoo with ketoconazole containing shampoo

After few week treatment you might feel better. Regular follow is needed,as the disease may relapse. I hope this would help you in your treatment.

Thanks.

Dr. Ilyas Patel MD
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Suggest Treatment For Itchy And Round Skin Rashes

Hi, It seems that you may be having seborrheic dermatitis. There may be flaky patches on chest,axillae and groin areas. There may be dandruff. Seborrheic dermatitis is an inflammatory skin condition. It may be precipitated by factors like stress,anxiety, sleeplessness,Oily skin (seborrhoea),Familial tendency , Immunosuppression due to organ transplant, human immunodeficiency virus (HIV) infection and others,Neurological and psychiatric diseases...like Parkinson disease, tardive dyskinesia, depression...etc. Yeast like mellessezia furfur may be associated. You consult dermatologist for firm diagnosis and treatment. I generally give treatment in my patients having such problem in following way.. -antifungal tablets like ketoconazole with steroid in tappering dose for few weeks. -antihistaminic like levocetirizine till itch and discomfort is reduced. - vitamin like folic acid may be taken for long time. - associated disease may be treated. -Keratolytics to remove scale used when necessary, eg salicylic acid, lactic acid, urea, propylene glycol -Topical antifungal agents to reduce Malassezia eg ketoconazole, or ciclopirox cream or zinc pyrithione or selenium sulphide lotion -Mild topical corticosteroids for 1-3 weeks to reduce inflammation in acute flare like mometasone. -Topical calcineurin inhibitors (pimecrolimus cream, tacrolimus ointment) as required - for dandruff, shampoo with ketoconazole containing shampoo After few week treatment you might feel better. Regular follow is needed,as the disease may relapse. I hope this would help you in your treatment. Thanks. Dr. Ilyas Patel MD