[37M] Experiencing flaky, itchy scalp with moderate symptoms

Patient Description

A 37-year-old male is reporting a 3-week history of flaky skin on the scalp, localized to a less than 5-inch diameter area on the left side. The affected skin is itchy, yellowish, and has developed a brown circle. The patient experiences moderate itchiness and has noticed oozing from the area after picking at the flakes. There is a past medical history of dermatitis diagnosed at age 15. The patient is currently taking Lipitor, Wellbutrin XL, Allegra, Flonase, and a daily vitamin supplement. No known drug allergies. No other symptoms have been reported.

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Arora's Assessment

What might be happening

Based on the symptoms you've described, the following conditions could be possible:

  • Seborrheic Dermatitis: This is a common skin condition that mainly affects your scalp. It causes scaly patches, red skin, and stubborn dandruff. Seborrheic dermatitis can also affect oily areas of the body, such as the face, sides of the nose, eyebrows, ears, eyelids, and chest. It can also cause itching and the scales can be yellowish in color.

    • Treatment typically involves medicated shampoos, creams, and lotions.
  • Psoriasis: This is a skin disease that causes red, itchy scaly patches, most commonly on the knees, elbows, trunk, and scalp. Psoriasis is a chronic disease that often comes and goes.

    • Treatment options include steroid creams, vitamin D3 cream, ultraviolet light, and immune system suppressing medications, among others.
  • Scalp Ringworm (Tinea Capitis): This is a fungal infection of the scalp that primarily affects children. It can present as scaly, itchy patches on the scalp.

    • Treatment typically involves antifungal medications.

Please note that these are potential conditions based on the symptoms you've described. It's important to consult with a healthcare professional for an accurate diagnosis.

What you can do

  1. Avoid scratching the area as much as possible. This can lead to further inflammation or potential infection.
  2. Try over-the-counter dandruff shampoos that contain zinc or selenium.
  3. Keep the area clean and dry.
  4. Avoid any hair products that may cause irritation.

What you should look out for

  • If the area becomes increasingly red, swollen, or painful
  • If you develop a fever
  • If the condition continues to worsen or does not improve with over-the-counter treatments

Remember, it's important to consult with a healthcare professional for an accurate diagnosis and treatment.

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11 mo ago

People Also Ask


What are the common symptoms of seborrheic dermatitis?

Common symptoms of seborrheic dermatitis include scaly patches, red skin, and stubborn dandruff, often accompanied by itching. The scales can be yellowish and oily, and the condition typically affects areas with a lot of oil glands, such as the scalp, face, and chest.


How can I differentiate between psoriasis and seborrheic dermatitis on the scalp?

Psoriasis and seborrheic dermatitis can both cause scaly patches on the scalp, but psoriasis scales are often thicker and more silvery, while seborrheic dermatitis scales are usually yellowish and greasy. Psoriasis may also cause more distinct red patches and can affect other areas like the elbows and knees.


What are the treatment options for scalp ringworm?

Treatment for scalp ringworm typically involves oral antifungal medications, as topical treatments are often not effective enough. It's important to follow the prescribed treatment plan to ensure the infection is fully cleared.


Can my current medications affect my skin condition?

While the medications you are taking, such as Lipitor, Wellbutrin XL, Allegra, and Flonase, are not directly known to cause skin conditions like seborrheic dermatitis or psoriasis, they can sometimes have side effects that affect the skin. It's best to discuss any concerns with your healthcare provider.


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