Seborrhoeic Dermatitis HIV — SCE Infectious Diseases MCQ

Instant feedback + full explanation. One question, done properly.

EasyHIV MedicineSeborrhoeic Dermatitis HIVSCE Infectious Diseases

A 40-year-old man with HIV develops a disfiguring facial rash consisting of erythematous scaling plaques in the nasolabial folds, eyebrows, and scalp. It has been present for months. He has well-controlled HIV (CD4 420, VL <50). Skin scraping shows no fungal hyphae. What is the most likely diagnosis?

Educational content. Not a substitute for clinical judgement or local policy.

Reveal the answer and explanation

Correct answer: A — Seborrhoeic dermatitis — extremely common in HIV (occurring in up to 80% of PLWH), often more severe and extensive than in the general population

Seborrhoeic dermatitis is the most common skin condition in HIV, affecting up to 80% of PLWH. It is caused by an inflammatory response to Malassezia furfur yeast on the skin. In HIV, it tends to be more severe, extensive, and treatment-resistant than in immunocompetent patients. It can persist even with well-controlled HIV/immune reconstitution. Treatment: topical Ketoconazole 2% cream/shampoo (anti-Malassezia) plus topical mild corticosteroid (Hydrocortisone 1%) for flares. The nasolabial folds, eyebrows, scalp, and chest are typical locations.

Reference: BHIVA 2022 – Dermatological conditions in HIV; BAD 2023 – Seborrhoeic dermatitis; NICE CKS