Internal Medicine

0521779407-19 CUNY1086/Karliner 0 521 77940 7 June 4, 2007 21:21

1332 Seborrheic Dermatitis Seborrheic Keratosis

➣dandruff shampoos with ketoconazole, ciclopirox, or selenium

sulfide

specific therapy

■Mild topical corticosteroids (class 6 or 7) or the topical calcineurin

inhibitors or antifungal creams

■Scalp involvement, use selenium sulfide, ketoconazole, cyclopirox

or zinc shampoo; if severe in scalp, mid- to high-potency topical

corticosteroid solution

■If severe facial involvement, use a mid-potency nonfluorinated top-

ical steroid (Class 4 or 5) <7 days, then taper back to the milder forms

■Refractory cases may try oral azole antifungals

follow-up

■Follow up for improvement and side effects

complications and prognosis

n/a

SEBORRHEIC KERATOSIS

JEFFREY P. CALLEN, MD

history & physical

History

■Asymptomatic lesions

■Symptoms may occur from irritation from clothing or jewelry.

■Solitary lesions are less common than multiple lesions.

Signs & Symptoms

■Flat or elevated lesions

■Verrucous surface

■Sharply marginated

■“Stuck-on” appearance

■Small, multiple facial lesions in patients of color are known as der-

matosis papulosa nigra.

tests

■None needed

differential diagnosis

■War ts