Seborrheic dermatitis is a common inflammatory disorder characterized by greasy scale, itching, and erythema. It commonly affects areas of the skin that have high sebum production or are sebaceous gland-rich, including the scalp, face, sternum, axilla, groin, and other skin folds. Seborrheic dermatitis can present in infants, adolescents, and adults, and is more common in men. The etiology is not fully understood, but contributing factors include presence of the yeast genus Malassezia, androgen levels, immunosuppression, family history, and stress or lack of sleep. Interestingly, those with neurological and psychiatric conditions, including Parkinsons Disease, spinal cord injury, epilepsy, and tardive dyskinesia, are often more severely affected. This may be due to changes in dopamine and greater production of sebum. In these patients, seborrheic dermatitis can present more extensively, with larger salmon-pink, scaly plaques, some of which can even appear petaloid or ring shaped. Awareness of seborrheic dermatitis is important as every primary care clinician will see patients with this common disorder. Efficient identification can expedite proper therapy and reduce symptoms, while education can alleviate psychological distress. Common mimicking diagnoses include psoriasis, atopic dermatitis, tinea infections, and pityriasis rosea. The presented case was a hospital consultation for psoriasis vs extensive fungal infection, in a patient with severe cervical spinal stenosis. Case Presentation: A 64-year-old man with severe spinal stenosis was admitted to the hospital for cervical spinal fusion. Dermatology was consulted for psoriasis vs extensive fungal infection. On examination, there was erythema with fine greasy scaling to scalp, face, and ears, with thicker scaling to nasolabial folds and eyebrows. There were also salmon-pink scaly plaques to chest and sternum. He was treated with ketoconazole 2% shampoo, as he was being treated with also being treated with IV corticosteroids per surgery, and experienced rapid improvement in symptoms. Learning points: We share this case demonstrating a case of seborrheic dermatitis in a patient with severe spinal stenosis. Physical exam findings revealed salmon-pink plaques to chest and sternum, with erythema and fine greasy scaling to face, scalp and ears, with thicker scaling in nasolabial folds and eyebrows. This case highlights the importance of understanding the distribution and conditions associated with seborrheic dermatitis, as many other diseases can be easily confused for it. All primary care physicians will encounter patients with seborrheic dermatitis and they should take these points into great consideration when diagnosing patients.