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Seborrhoeic Dermatitis — SCE Dermatology MCQ

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EasyInflammatory DermatosesSeborrhoeic DermatitisSCE Dermatology

A 50-year-old man with severe scalp seborrhoeic dermatitis asks about the first-line topical antifungal treatment. Which agent has the best evidence?

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Correct answer: C — Topical Ketoconazole 2% shampoo

Topical Ketoconazole 2% shampoo is first-line antifungal treatment for scalp seborrhoeic dermatitis. It targets Malassezia species (the lipophilic yeast implicated in the condition) and has anti-inflammatory properties. It should be used as a shampoo 2-3 times weekly initially then once weekly for maintenance. Coal tar shampoo is an alternative. For facial seborrhoeic dermatitis, topical Ketoconazole 2% cream or topical Miconazole are options. Mild topical corticosteroids (Hydrocortisone 1%) can be used short-term for inflammatory flares. Topical calcineurin inhibitors are steroid-sparing alternatives for facial disease.

Reference: BAD 2016 SD Patient Information; NICE CKS