Dandrugg and seborrheic dermatitis Flashcards
what is dandruff and seborrheic dermatitis
- Dandruff (pityriasis simplex capitis) and seborrheic dermatitis (SD) are papulosquamous cutaneous disorders
- both cause scaling associated with itching
- dandrugg is a milder non inflammatroy form of SD and is limited to scalp
- SD is an inflammatroy condition with erythematous and scaling eruptions in “seborrheic areas” (scalp, face and upper trunk)
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who is most often affected by dandruff and SD
- Dandruff usually begins 10-20 and efefcts up to 50% of indivduals over 30
- SD is found in 1-5% of population, 30-33% of immunocompromised patietns and 83% of HIV
- Sd is most common in first 3 months of life and between 30-50
- affects more amles -> androgens affect secaceous galnd activity
development of SD
- controversy over cuase
- some say that fungal disease, others say fungal disease is secondary to the primary inflammatroy dermatosis that results in icnreased cell turnover, scalling and inflammation in epidermis
*means that treatments vary ranging from topical antifungals to topical corticosteroids and calcineuin inhibitors
*no direct relationship between amount od sebum and condiiton
*suggested response to materanl androgen stimulation
what are the goals of therapy for dandruff
Reduce or eliminate scales (dry flakes of skin) and flaking
Prevent recurrence by improving scalp hygiene
Eliminate or reduce environmental triggers
goals of therapy for seborrheic dermatitis
Control not cure
Reduce fungus and the resulting scaling and inflammation
Relieve symptoms such as pruritus
Educate on the importance of control through good hygiene
Eliminate or reduce environmental triggers
what to assess for in patients
Onset, frequency and duration of symptoms
Area and extent of involvement
Description of skin lesions
Associated systemic symptoms
Aggravating factors
Current hygiene practices
Attempted treatments
what are the symptoms of dandrugg and seborrheic dermatitis
- lesions of SD and dandrug are often asymptomatic
- variations in intensity of episodes can be precipitated by fature, stress or cold weather
- dandruff is usually asymptomatic, although itching amy develop
- in SD puritus varies, being common in scalp and ear canal involvement and can be intense
what are the sings of dandruff
- shedding of small fales from scalp showign minimal erythema with limited or no inflammation
- scales are silver-grey in patches or diffuse and may separate fully or become detached after combind
- no evidence of skin disease on scalp or elsewhere
- oftne confused with SD, tinea capitis and psoriasis
what is SD charcterized by
sharply demarcated yellow to brown, greasy or bran-like scaling patches and plaques.
- typically affects symmetic areas of skin rich in secaceous glands (hary areas of scalp, scalp margin, eyelashes, browns, beard and mustache)
- ca also affect nasolabial folds, forehead, outer ear canals and in the creases behind the ears
- can happen on torso
progression of SD
- begins in small patches, rapidly spreading, with diffuse fine scales that can be white, off-white or yellow with no signs of acute dermatitis such as oozing or weeping
- Exudation may be seen in facial SD from time to time.
* can rpesent diff in indivual with dark coloured skin, appearing scaly hypopigmented macules and patches in typical areas of involvement
patterns to SD flares
resolves in a cyclic or seasonal fashion, often in response to stress.
effect of SD on eyes
- profuse powdery scales on eyeborwns and compromize wearing of contact lenses
- eyelides alone can be affected, developing blepharitis
paranasla involement of SD
typically seen in young women who may not have dandruff.
most common type fo facial SD in males
upper lip, beard, scalp, back, flanks and abdomen.
Plaques may present with thick, adherent silvery scales (as seen with psoriasis), which usually spare the face, called sebopsoriasis.
SD in infants
entire scalp may be covered with thick, dry adherent, yellowish brown scalres overlying erythema
- called ‘cradle cap”
- can also invovle central face, forehard and ears
*self limting, appears in first to fourth week fo life and usually disappears in 3 months
diagnosing SD
must be distinguished from dandruff and psoriasis
as well as tinea capitis, atopic dermatitis, rosacea, systemic lupus erythematosus and fungal skin infections.
*refer when diagnosis is uncertain or failure to respond to first line treatment after 4 weeks
what factors aggredate SD
- gnertic predisposion
- HIV positing or AIDS
- neurologi condition like parkinsons
being middle aged or elderly
- cold dry weather
- infection stress, sleep deprevation, sweat, emotional stress
- comorbid condition like pityriasis versicolor, psychiatric disorders, lcoholic pancreatitis or hepatitis C or hyperandrogen syndromes in females
what drugs are knwon to cause SD
diagnosing dadruff vs SD
- dandruff = Dry, white scales scattered diffusely over scalp
SD: Greasy, yellowish scales on face parts and scalp or eddish-brown fine scaling patches on trunk and body folds
