Clinical Manual for Management of the HIV-Infected ... - myCME.com

6–96 | Clinical Manual for Management of the HIV-Infected Adult/2006
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Noncorticosteroid topical immunomodulators
(eg, tacrolimus, pimecrolimus) are helpful in
atopic dermatitis and may be useful for seborrheic
dermatitis.
Oral therapy may be used for patients refractory
to topical treatment (check for possible drugdrug
interactions with antiretroviral and other
medications before prescribing).
Itraconazole 200 mg once daily for 7 days (safest
and best option)
Ketoconazole 200 mg once daily for no
more than 4 weeks (prolonged use may cause
hepatotoxicity)
Terbinafine 250 mg once daily for 4 weeks
Patient Education
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Although topical and oral medicines can relieve
symptoms, recurrence of symptoms is common.
Effective antiretroviral therapy also should be
considered to control the effects of HIV on the
immune system and thereby treat the underlying
cause of seborrheic dermatitis.
References
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Dunic I, Vesic S, Jevtovic DJ. Oral candidiasis and
seborrheic dermatitis in HIV-infected patients on
highly active antiretroviral therapy. HIV Med. 2004
Jan;5(1):50-4.
Faergemann J, Bergbrant IM, Dohse M, et al.
Seborrhoeic dermatitis and Pityrosporum (Malassezia)
folliculitis: characterization of inflammatory cells and
mediators in the skin by immunohistochemistry. Br J
Dermatol. 2001 Mar;144(3):549-56.
Gupta AK, Bluhm R. Seborrheic dermatitis. J Eur
Acad Dermatol Venereol. 2004 Jan;18(1):13-26; quiz
19-20.
Gupta AK, Ryder JE, Nicol K, et al. Superficial fungal
infections: an update on pityriasis versicolor, seborrheic
dermatitis, tinea capitis, and onychomycosis. Clin
Dermatol. 2003 Sep-Oct;21(5):417-25.
Rigopoulos D, Paparizos V, Katsambas A. Cutaneous
markers of HIV infection. Clin Dermatol. 2004 Nov-
Dec; 22(6):487-98.