Hi doctor, Please take a look at my case of skin dryness and flaking on my face. This is a cyclic condition which occurs almost every 7-8 months. The dryness persists for 1-2 months during which I also have general body itching over hands, legs and under my ribs on the sides. The strange thing is that after 1-2 months this dryness spreads to scalp followed by heavy dandruff and very heavy hair loss. This time the dryness and flaking is very extreme. I have attached seven photos. First three will show my skin condition. Fourth and fifth is how the skin flakes after scratching. Sixth one is important as it shows clearly how the skin condition proceeds from my forehead up towards my scalp. But, it has not yet reached inside my scalp. Last photo is a dark patch under the side of my ribs due to itching, which is present on both sides. I feel that I have some internal fungal or bacterial infection that shows up again and again in a cyclic manner. I am diabetic too. Please help with my condition.
Hi. First of all I would like you to thank for giving me a perfect clinical history with perfect photographs (attachment removed to protect patient identity). It is a crystal clear case of seborrheic dermatitis and is moderate in nature. It is a fungal infection and is very chronic in nature. Like diabetes, it can only be controlled and cannot be cured permanently as the fungus causing it is a normal resident of skin. Whenever the condition becomes suitable for it, it proliferates. The good news is that it is harmless. Diabetes can also cause severe seborrheic dermatitis, because increased sugar gives fungus a suitable environment to proliferate. As I said already that it is a chronic condition, follow up is very necessary. Currently, I will give you medicines for a month. Make sure to review your condition after a month as the dose and course would be decided accordingly. Prescription is as follows: Recommended investigations are liver function test and renal function test. Once these investigations came out to be normal you can safely start tablet Nizoral. Revert back after a month for review to a dermatologist online -->