
What Is The Cause And Treatment For Recurrent Lesions On Scalp?

History and pictures required
Detailed Answer:
Hello,
Thank you for posting on HCM.
I can understand your apprehension regarding recurrent lesions on your scalp.
Considering your description, I would like to put forward differential diagnosis of bacterial folliculitis,seborrheic dermatitis, Folliculitis decalvans, Fungal infection(Tinea capitis).
Since the accurate diagnosis is not possible without actual clinical examination, I would insist you to post some good quality clinical pictures.You can mail pictures to YYYY@YYYY
with subject titled ' ATTN Dr Hardik Pitroda'.
Apart from pictures I would require you to provide certain history details like:
1. Any associated loss of hair? if yes, are there well defined patches of hair-loss?
2. Any associated scaling or flakiness in scalp?
3. Any itching?
4. History of exacerbation in particular weather?
5. Application of any hair-color or dyes or use of any cosmetics on scalp?
6. History of use of blow-dryers or hair straightening iron ?
7. Any history of Diabetes or any other immunocompromised condition?
Thanks
Dr Hardik Pitroda


2) no scales or flakes
3) itches when scabbing over after picking noal I know
4) no dyes or hair product, no blow drying curling or straightening have used same shampoo for years but tried suave and tgel and white rain when this started no improvement after 2 weeks with each
5) diabetic well controlled hgb a1c 5.9
Just last month.
I do pick as they annoy the heck out of me and it's like pressure builds up under it and once it opens it no longer hurts like it did. No drainage other than when I remove scabs and it bleeds. The pictures I sent you are one that popped up the day I posted it has been hardly messed with which is why I sent it. I have not picked at it except a few times. Was thinking of trying tea tree oil. I just know they bug me and I am a picker when I'm stressed or not thinking and it is embarrassing
Oral antifungals, topical antifungal and corticosteorid
Detailed Answer:
Considering you history and pictures, I would like to treat you for seborrheic dermatitis.
Sebaceous hyperplasia is enlarged and swollen sebaceous glands which produces excessive sebum and this in turn can lead to dermatitis of skin called Seborrheic dermatitis. Excess sebum production promotes fungal growth and these in turn eventually contributes to seborrheic dermatitis.
I would suggest you a course of oral antifungal drug like fluconazole 150mg once a week for 6-8weeks.
Also in addition, I would like to add an antibiotic like Doxycycline 100mg twice a day for 20-30 days.
Mix and apply a lotion containing betamethasone plus clotrimazole and clindamycin lotion twice a day over scalp.
Use a shampoo containing povidone-iodine thrice a week for scalp wash (Betadine-AD shampoo)
Please do update me after 3 weeks of above therapy.
I am sure you will be fine with this treatment.
Let me know if you require any more assistance from my side.
Wish you best of health.
Thank you
Dr Hardik Pitroda
M.D Dermatology


Wish you good health
Detailed Answer:
You are welcome.

Answered by

Get personalised answers from verified doctor in minutes across 80+ specialties
