seborrhea - progressive/spreading or ... something else?

[wondering36]

My saga started 4 years ago... with a 1.5'' or so patch at sternum that refused to tan in the Summer. Was prescribed combination of streoid and anti-fungal creams, but by next Summer it still didn't tan.
By next year, my scalp became very scaly and particularly bad from Autumn to Spring, no notable problems in Summer. That persisted despite using ketoconazole-based shampoo (although it helped a bit, but condition returned every Autumn).
It also spread to my forehead where from Autumn to Spring the skin gets very dry and scaly, also areas under eyes and sides of my nose are affected. None of those areas want to tan and just get red when exposed to sunshine, but scaling is very much reduced in Summer.
I really don't know what to do as my doctor just prescribes steroid + antifungal and refuses to send me to specialist.
Then I noticed non-itchy, scaly spots on scrotum that became progessively larger, then some small areas on penis, too. Very mild steroid cream helped for 1-2 weeks, then it starts all over again.

Can there be some infection or underlying condition that makes dermatitis spread progressively? Or is it just something that started on its own and gets worse?

Is there anything I can try as it is started to really scare me, every Autumn/Winter it just gets worse and worse.

Yours in hope...

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[wondering36]

36 years old male

[Alan Rockoff, MD]

It's hard for me to tell whether all the different areas you're describing are the same thing.  It does seem clear, though, that you don't have any infection or underlying condition.  Most likely you have some form of eczema, which often comes and goes with no real pattern, and which can interfere with skin pigmentation to a limited--and reversible--extent.  I recommend you see a skin specialist who can see what you have and diagnose something more specific than a 'shotgun' like steroid plus antifungal.  If your doctor refuses to send you to a specialist, find another doctor.  It would take one visit, and withholding that is unreasonable, and I think you should say so.  You're worrying way too much, so you need more reliable information and better treatment.

Best.

Dr. Rockoff